Date of Award

12-2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of this selective EBM review is to determine whether or not Necitumumab is an effective add on treatment to traditional chemotherapy regimes when treating stage IV lung or colon cancer.

Study Designs: Review of two open label, randomized, controlled phase III trials and one single arm multicenter phase II study.

Outcomes Measured: Objective tumor response rate was measured for patients with colon cancer. Overall survival rate and length of survival were measured for patients with lung cancer. This was measured in Kapler Meier Methodology.

Results: For two trials the addition of Necitumumab improved overall survival and tumor response rate. The first lung cancer trial did not show improvement of survival rate with Necitumumab. In this trial those receiving the experimental drug had a median survival of 11.3 months compared to 11.5 in those not receiving the experimental medicine. The second lung cancer trial saw survival times as 11.5 months with Necitumumab compared to 9.9 months without it. In the third trial all patients were given Necitumumab in addition to FOLFOX agents for colon cancer. Tumor response rate was compared between those with a KRAS wildtype gene mutation and those with a KRAS mutant gene mutation. The results showed a higher tumor response rate for those with the wildtype mutation, however both groups saw positive reduction in tumors.

Conclusion: The addition of Necitumumab to traditional chemotherapy regimes is an effective way to fight stage IV cancer, especially in those with a KRAS wildtype mutation or with squamous non-small cell lung cancer. It is less effective for non-squamous non-small cell lung cancer.

Included in

Oncology Commons

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