Meta-analysis of incidence and risk of hypokalemia with cetuximab-based therapy for advanced cancer

Abstract

To gain a better understanding of the incidence and risk of hypokalemia in patients who received cetuximab-based therapy. Databases, including Pubmed, EMBASE, The Cochrane Library, annual meeting of American Society of Clinical Oncology (2000-2008), and Web of science were searched to identify relevant studies. Eligible studies were prospective phase II-III clinical trials of patients with cancer assigned cetuximab at the dose of 400 mg/m(2) IV on day 1 and 250 mg/m(2) weekly thereafter. The primary endpoint was incidence of hypokalemia. Eleven clinical reports were identified which included a total of 2,254 patients who were available for analysis, with 1,324 patients assigned cetuximab-based treatment. The results showed high incidence of grade 3 and 4 hypokalemia [6.2% (95% CI 4.9-7.7)] and high incidence of all-grade hypokalemia [8.0% (95% CI 4.5-13.9)] associated with cetuximab-based therapy for advanced cancer. Compared with non-cetuximab therapy, cetuximab-based therapy has higher risk of grade 3 and 4 hypokalemia [1.81 (95% CI 1.12-2.93)]. Cetuximab-based therapy is associated with a significant risk of hypokalemia. Early monitoring and effective management of hypokalemia is important for patients that received cetuximab-based therapy.