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Poster display session

5158 - Efficacy of anti-EGFR antibodies combined with chemotherapy for elderly patients with RAS wild-type Metastatic Colorectal Cancer: A Systematic Review and Metanalysis.


09 Sep 2017


Poster display session


Cytotoxic Therapy;  Geriatric Oncology;  Colon and Rectal Cancer


Lorenzo Belluomini


Annals of Oncology (2017) 28 (suppl_5): v158-v208. 10.1093/annonc/mdx393


L. Belluomini1, I. Carandina1, F. Bonetti2, B. Urbini1, F. Daniel1, F. Lancia1, L.R. Martella1, I. Toma1, A. Moretti1, E. Bannò1, C. Nisi1, L. Da Ros1, A. Frassoldati1

Author affiliations

  • 1 Medical Oncology, Azienda Ospedaliera di Ferrara St. Anna, 44100 - Ferrara/IT
  • 2 Internal Medicine, Azienda Ospedaliera di Ferrara St. Anna, 44100 - Ferrara/IT


Abstract 5158


The incidence of Colorectal Cancer (CRC) increases with age, reaching a peak around 70-75 years. The anti-EGFR monoclonal antibodies combined with chemotherapy represent a valid option in patients with RAS wild-type (wt) metastatic CRC (mCRC), allowing a significant improvement in survival. However, few data are available regarding the use of these agents in the elderly population. The aim of the study is to evaluate the efficacy of adding anti-EGFR monoclonal antibodies (Cetuximab or Panitumumab) to chemotherapy in the treatment of RAS wt mCRC older patients.


A systematic review of the published data using PubMed and EMBASE databases and the congress documents of the main national and international symposia was performed. The random effect model was used to combine the effect estimates, the I2 and Cochran's Q index to quantify the between-study heterogeneity unexplained by sampling error.


Four randomized trials (two regarding Cetuximab and two Panitumumab combined with 5-FU based doublet chemotherapy) have been selected among the 2765 initially identified studies. None of the studies had been specifically designed for the elderly population, so PFS and OS HR values were extracted from pre-specified subgroup analyses. In our study, 605 elderly patients were included: 289 patients received only chemotherapy and 316 patients received chemotherapy in combination with anti-EGFR antibodies. The meta-analysis showed a statistically significant benefit of the combination of chemotherapy and anti-EGFR against chemotherapy alone both in terms of PFS (HR 0.79, IC 95% 0.64-0.98, p = 0.028, Q = 2.54, df = 3, I2 = 0%) and OS (HR 0.82, IC 95% 0.68-0.98, p = 0.032, Q = 0.57, df = 3, I2 = 0%). The subgroup-analyses confirmed that the Panitumumab studies had a major impact than Cetuximab ones on the final metanalysis result.


The addition of Cetuximab or Panitumumab to chemotherapy could represent a valid therapeutic option in terms of efficacy, also in elderly patients with RAS wt mCRC. However, the available data in this subset of patient are limited. Dedicated studies are needed in order to determine the best therapeutic strategy.

Clinical trial identification

Legal entity responsible for the study

Azienda Ospedaliero-Universitaria di Ferrara




All authors have declared no conflicts of interest.

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