• Yong Xin, Qiuyue Yan, ChunSheng Yang, Fan Jiang, Wenwen Guo, Qian Huang, Guan Jiang, and Longzhen Zhang.
• Department of Radiation Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou.
• Medicine (Baltimore). 2018 Dec 1; 97 (51): e13717e13717.

BackgroundWe performed a meta-analysis to compare the efficacy and safety of anti-epidermal growth factor receptor (EGFR) therapy and non-anti-EGFR therapy in recurrent/metastatic (RM) head and neck squamous cell carcinoma (HNSCC).MethodsThe Cochrane library, WanFang Data, PubMed, Medline, VIP, CBM, and EBSCO databases were searched for relevant studies. The objective response rate (ORR, defined as complete response or partial response according to RECTST version 1.1) and grade 3 to 4 adverse effects were used.ResultsTen studies involving 2260 patients were included. Primary meta-analysis showed that anti-EGFR therapy improved the ORR [odds ratio (OR): 1.79, 95% confidence interval 1.44-2.21, P <.00001]. Subgroup analyses revealed that the ORR of patients with RM HNSCC could be improved by monoclonal antibodies (OR: 1.89, 1.46-2.45, P <.00001) and tyrosine kinase inhibitors (OR: 1.57, 1.07-2.31, P = .02). Analysis of grade 3 to 4 adverse effects demonstrated that diarrhea (3.15, [1.90, 5.20]), rash/desquamation (13.66, [6.86, 27.20]), hypomagnesemia (1.83, [1.28, 2.62]), vomiting (1.99, [1.00, 3.95]), anorexia (3.34, [1.45, 7.73]), dehydration (2.22, [1.19, 4.12]), and hypokalemia (1.63, [1.09, 2.42]) were significantly associated with anti-EGFR therapy.ConclusionAnti-EGFR therapy is recommended for patients with RM HNSCC. Adverse effects, such as diarrhea, anorexia, hypomagnesemia, and hypokalemia, should be carefully monitored during anti-EGFR therapy.

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