FCGR2A and FCGR3A polymorphisms predict prognosis in metastatic colorectal cancer patients treated with cetuximab-based therapies: a systematic review and meta-analysis
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
Authors: Chen, Xiaowan; Sun, Jingxu; Song, Yongxi; Gao, Peng; Ma, Bin; Zhang, Cong; Liu, Hongpeng; Wang, Jiajun; Wang, Zhenning
Abstract
A meta-analysis of the FCGR2A H131R and FCGR3A V158F polymorphisms in patients with metastatic colorectal cancer was performed to assess the association between these genetic polymorphisms and the clinical efficacy and prognostic value of cetuximab-based therapies. A search of the PubMed and EMBASE databases identified 11 published studies including 907 patients treated with cetuximab-based regimens. The clinical response, disease control rate (DCR), and prognosis were evaluated using a fixed or random effects model. Patients carrying the FCGR2A 131R allele (HR and RR genotypes) had a better clinical response than those with the FCGR2A 131HH genotype in the overall pooled analysis (HR+RR vs. HH; overall response rate (ORR) = 1.54; 95% confidence interval (CI) = 1.31-2.09; P = 0.01) and in subgroup analysis of patients who received cetuximab as a single agent (HR+RR vs. HH; ORR = 1.77; 95% CI = 0.95-3.28; P = 0.07). No significant association between the FCGR2A 131H/R polymorphism and DCR or prognostic factors was observed. Patients harboring the FCGR3A 158F allele had better DCR than those with the FCGR3 158VV genotype (VF+FF vs. VV; DCR = 1.45; 95% CI = 1.04-2.05; P = 0.03), whereas no significant differences between the two groups were observed in the clinical response rate or prognostic factors. Pooled analysis showed that FCGR3A V allele carriers had a better clinical response (VV+VF vs. FF; ORR = 0.59; 95% CI = 0.35-0.99; P = 0.05) and longer overall survival than those with the FCGR3A FF genotype (VV+VF vs. FF; HR = 0.79; 95% CI = 0.64-0.97; P = 0.03). This meta-analysis showed that the FCGR polymorphism is associated with treatment efficacy and the prognosis of patients with metastatic colorectal cancer treated with cetuximab.
Late-onset neutropenia following rituximab therapy: incidence, clinical features and possible mechanisms
EXPERT REVIEW OF HEMATOLOGY
Authors: Tesfa, Daniel; Palmblad, Jan
Abstract
Late-onset neutropenia (LON) is emerging as a common adverse effect to rituximab therapy owing to widespread use of this drug in the treatment of B-cell lymphomas and autoimmune diseases. However, the true incidence and mechanisms are not fully understood. LON has been reported in 5-27% of rituximab-treated lymphoma patients. Similar figures apply for autoimmune patients but they appear to have more infections during the neutropenic period. Recent reports imply that host factors may play an intriguing role for development of LON, for example, polymorphisms in FCGR3. Pronounced B-lymphocyte depletion and lower serum IgM, as reported in LON patients during the period of neutropenia compared with matched controls, may play a role for understanding the mechanisms and risk stratification for emergence of LON.