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The efficacy and safety of onartuzumab in patients with solid cancers: A meta-analysis of randomized trials
Bum Jun Kim1, Dalyong Kim2, Jung Han Kim1, Hyeong Su Kim1, Hyun Joo Jang1
1 Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea
2 Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
Background: Onartuzumab, a humanized monovalent monoclonal antibody to the MET protein, has been tested in various cancers. We conducted a meta-analysis of randomized phase II and III clinical trials to investigate the efficacy and safety of onartuzumab in solid cancers.
Methods: We searched PubMed, PMC, EMBASE, and the Cochrane library databases. We included randomized phase II or III trials that evaluated the additional benefits of onartuzumab in comparison with the standard treatments. Data on progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were pooled and analyzed.
Results: From nine studies, a total of 2,138 patients were included in the meta-analysis. The addition of onartuzumab to the standard treatment resulted in no improvement of PFS (hazard ratio (HR) = 1.00 [95% confidence interval (CI), 0.90–1.11], P = 0.93) and OS (HR = 1.08 [95% CI, 0.94–1.23], P = 0.29). In the subgroup analysis with patients with non-small-cell lung cancer (NSCLC), onartuzumab was not associated with a significant improvement of OS (HR = 1.12 [95% CI, 0.93–1.34], P = 0.23) and PFS (HR = 1.05 [95% CI, 0.91–1.21], P = 0.52). With respect to AEs, onartuzumab increased the incidence of hypoalbuminemia (odds ratio (OR) = 14.8 [95% CI, 3.49–62.71], P < 0.001), peripheral edema (OR = 6.52 [95% CI, 3.60–11.81], P < 0.001), neutropenia (OR = 1.36 [95% CI, 1.03–1.79], P = 0.03), thrombocytopenia (OR = 1.98 [95% CI, 1.03–3.81], P = 0.04), and venous thrombotic events (OR = 3.05 [95% CI, 1.39–6.71], P = 0.006).
Conclusion: This meta-analysis indicates that the addition of onartuzumab to the standard treatments had no definite survival benefit with increased severe toxicities in patients with solid cancer.
Hyun Joo Jang,
Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul
Republic of Korea
Source of Support: None, Conflict of Interest: None