Incidence and risk of hypomagnesemia in advanced cancer patients treated with cetuximab: A meta-analysis

Abstract

Hypomagnesemia is a serious adverse event for patients treated with cetuximab, an inhibitor of endothelial growth factor receptor (EGFR). However, no significant association has yet been established between cetuximab and hypomagnesemia in randomized controlled clinical trials (RCTs). The present study conducted a systematic review and meta-analysis of published RCTs to assess the overall risk of hypomagnesemia associated with cetuximab. PubMed, the Cochrane Central Register of Controlled Trials, Embase and the American Society of Clinical Oncology conferences were searched for relevant RCTs. Quantitative analysis was carried out to evaluate the association between hypomagnesemia and cetuximab. A total of 7,045 patients with a variety of advanced cancers from 10 trials were included in the analysis. The overall incidence of grade 3/4 hypomagnesemia in patients receiving cetuximab was 3.9% [95% confidence interval (CI), 2.6-4.3%]. Patients treated with cetuximab had a significantly increased risk of grade 3/4 hypomagnesemia compared with patients treated with control medication, with a relative risk (RR) of 8.60 (95% CI, 5.08-14.54). Risk was observed to vary with tumor type. The study concluded that cetuximab is associated with a significant risk of hypomagnesemia in patients with advanced cancer receiving concurrent chemotherapy.

Keywords: advanced cancer; cetuximab; hypomagnesemia; meta-analysis.

Figure 1

Selection process for RCTs included in the meta-analysis. RCTs, randomized controlled clinical trials.

Figure 2

Relative risk (RR) of hypomagnesemia associated with cetuximab treatment compared with control treatment. RR<1, numerically lower incidence than control chemotherapy; RR>1, numerically higher incidence than control chemotherapy. If 95% CI does not include the number 1 it demonstrates a significant difference between the two groups (P<0.05).