Anti-EGFR-targeting agents in recurrent or metastatic head and neck carcinoma: a meta-analysis.

Background: Anti-epidermal growth factor receptor (EGFR) therapies are effective in head and neck carcinoma. A meta-analysis was performed to assess their efficacy and safety in advanced head and neck carcinoma.

Methods: Six trials randomizing 2257 patients with recurrent/metastatic head and neck carcinoma for chemotherapy or best supportive care with or without anti-EGFR therapies were identified. The efficacy data included progression-free survival (PFS), overall survival (OS), response rate, and toxicity.

Results: The response rate was higher in the experimental arm (p < .0001; relative risk = 1.62). A significant PFS benefit (p < .0001; hazard ratio [HR] = 0.70) favored the anti-EGFR treatment. Survival was significantly increased if trials of monoclonal antibodies were included (p = .004; HR = 0.83). A higher incidence of diarrhea, skin rash, anorexia, and hypomagnesemia was observed.

Conclusions: This meta-analysis suggests that in recurrent/metastatic head and neck cancer the addition of anti-EGFR monoclonal antibodies to standard therapy confers a statistically significant improvement in OS, PFS, and overall response rate.