Necitumumab added to first-line chemo improves overall survival in advanced NSCLC

Adding necitumumab to first-line chemotherapy in patients with stage IV nonsmall-cell lung cancer (NSCLC) leads to a statistically significant improvement in overall survival, but not progression-free survival and objective response rate, according to a recent meta-analysis.

The investigators conducted a comprehensive literature search according to prespecified inclusion and exclusion criteria, and extracted data on overall survival, progression-free survival, objective response rate, and adverse events. A meta-analysis was then carried out to obtain pooled hazard ratios (HRs) and corresponding 95 percent confidence intervals (CIs) for time-to-event data and pooled odds ratio (ORs) with 95 percent CI for dichotomous outcomes.

Four randomized controlled trials with 2,074 patients were included in the meta-analysis. Pooled results showed significant improvement in overall survival (HR, 0.87, 95 percent CI, 0.79–0.95; p=0.004) when necitumumab was added to chemotherapy in advanced NSCLC patients. However, there was no statistically significant improvement seen in progression-free survival (HR, 0.83, 95 percent CI, 0.69–1.01; p=0.06) and objective response rate (OR, 1.46, 95 percent CI, 0.90–2.38; p=0.13).

Subgroup analysis revealed no benefit in overall survival and objective response rate in patients with nonsquamous NSCLC. Furthermore, those with advanced NSCLC treated with necitumumab were at increased risk of developing a skin rash (OR, 14.50, 95 percent CI, 3.16–66.43; p=0.0006) and hypomagnesaemia (OR, 2.77, 95 percent CI, 2.23–3.45; p<0.00001); the OR for any grade ≥3 adverse event was 1.55 (95 percent CI, 1.28–1.87; p<0.00001).

“Almost half of patients with NSCLC are diagnosed at an advanced stage,” the investigators noted.