@Article{Huang2014,
journal="Archives of Medical Science",
issn="1734-1922",
volume="10",
number="1",
year="2014",
title="Systematic review/Meta-analysis
Anti-epidermal growth factor receptor monoclonal antibody-based therapy for metastatic colorectal cancer: a meta-analysis of the effect of PIK3CA mutations in KRAS wild-type patients",
abstract=" Introduction:  We conducted a meta-analysis to dissect the association between  PIK3CA  mutations (exon 9 and exon 20) and resistance to anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MoAbs) in  KRAS  wild-type metastatic colorectal cancer (mCRC) patients.   Material and methods:  In 11 previously published studies, 864 cancer patients were treated with cetuximab or panitumumab-based therapy. Primary outcomes included objective response (complete response + partial response vs. stable disease + progressive disease), progression-free survival (PFS), and overall survival (OS). We calculated the odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CIs) to estimate the risk or hazard. We found consistent and clinically substantial risk or hazard for objective response, PFS, and OS in the cetuximab or panitumumab-treated mCRC patients.    Results :  PIK3CA  mutations as a whole were associated with reduced response and poor PFS and OS in  KRAS  wild-type mCRC patients (objective response: OR = 0.42 and 95% CI 0.23–0.75; PFS: HR = 1.54 and 95% CI 1.13–2.09; and OS: HR = 1.4 and 95% CI 1.02–1.91).  PIK3CA  exon 9 mutations had no effect, whereas exon 20 mutations were associated with a worse outcome compared with wild types, with an OR of 0.21 (95% CI 0.05–0.93).   Conclusions :  PIK3CA  mutations as a whole might be useful prognostic factors for assessing clinical outcomes of anti-EGFR MoAb-based chemotherapies in  KRAS  wild-type mCRC patients. In particular,  PIK3CA  exon 20 mutations were significantly associated with lack of response.",
author="Huang, Lulu
and Liu, Zhenfang
and Deng, Donghong
and Tan, Aihua
and Liao, Ming
and Mo, Zengnan
and Yang, Xiaobo",
pages="1--9",
doi="10.5114/aoms.2014.40728",
url="http://dx.doi.org/10.5114/aoms.2014.40728"
}