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Germline polymorphisms as biomarkers of tumor response in colorectal cancer patients treated with anti-EGFR monoclonal antibodies: a systematic review and meta-analysis

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Abstract

Studies of germline polymorphisms as predictors of tumor response to anti-epidermal growth factor receptor (EGFR) monoclonal antibody agents in metastatic colorectal cancer have reported inconsistent results. We performed a systematic review of studies from 1990 to September 2015, followed by random-effects meta-analyses for polymorphisms examined in at least three studies. Of 87 studies, 40 passed the criteria for systematic review and 23 for meta-analysis. The polymorphisms suitable for meta-analysis were CCND1 (rs17852153), COX2 (rs20417), EGF (rs4444903), EGFR (rs712829, rs11543848, 3′UTR CA repeat), FCGR2A (rs1801274), FCGR3A (rs396991), IL8 (rs4073), KRAS (rs61764370) and VEGFA (rs3025039). Meta-analysis yielded nominal significance (at α=0.05) for rs4444903 and rs11543848, but showed no significant results after multiple testing correction; this was unchanged by sensitivity analyses to address subgroups, funnel-plot asymmetries, and study quality. This highlights a tendency for lack of replication in the face of initial positive results, and possibly the unsuitability of relying on tumor response as a surrogate marker in this setting.

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Correspondence to E K Morgen.

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Competing interests

H-JL: advisory board member for Merck KG, Bristol Myers Squibb clinical trial support, Merck Serono and Bristol Myers Squibb. GM: Merck Serono honorarium. JZ: travel and research support to Merck Serono. CSK: advisory board member for Amgen and Merck Serono. AD: advisory board member for Amgen. GL: advisory board member for Roche, Astra Zeneca, Novartis, Pfizer and Merck Serono. The remaining authors declare no conflict of interest.

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Morgen, E., Lenz, HJ., Jonker, D. et al. Germline polymorphisms as biomarkers of tumor response in colorectal cancer patients treated with anti-EGFR monoclonal antibodies: a systematic review and meta-analysis. Pharmacogenomics J 17, 535–542 (2017). https://doi.org/10.1038/tpj.2016.56

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