summary
GRADE
treatment
patients
risk of bias
overview
deaths (OS) deaths (OS) (extension) DOR objective responses (ORR) progression or deaths (PFS) AE (any grade) AE leading to death (grade 5) AE leading to treatment discontinuation (any grade) TRAE (any grade) TRAE (grade 3-4) TRAE leading to death (grade 5) TRAE leading to discontinuation (any grade) TRAE leading to discontinuation (grade 3-4) Acute kidney injury TRAE (grade 3-4) Adrenal insufficiency TRAE (grade 3-4) Alopecia TRAE (grade 3-4) Anaemia TRAE (grade 3-4) Arthralgia TRAE (grade 3-4) Asthenia TRAE (grade 3-4) Blood and lymphatic system disorders TRAE (grade 3-4) Blood creatinine increased TRAE (grade 3-4) Cardiac disorders TRAE (grade 3-4) Chills TRAE (grade 3-4) Colitis TRAE (grade 3-4) Constipation TRAE (grade 3-4) Cough TRAE (grade 3-4) Decreased appetite TRAE (grade 3-4) Diarrhoea TRAE (grade 3-4) Dyspepsia TRAE (grade 3-4) Dyspnoea TRAE (grade 3-4) Endocrine disorders TRAE (grade 3-4) Epistaxis TRAE (grade 3-4) Eye disorders TRAE (grade 3-4) Fatigue TRAE (grade 3-4) Febrile neutropenia TRAE (grade 3-4) Gastritis TRAE (grade 3-4) Gastrointestinal disorders TRAE (grade 3-4) General disorders and administration site conditions TRAE (grade 3-4) Guillain-Barré syndrome TRAE (grade 3-4) Headache TRAE (grade 3-4) Hepatitis TRAE (grade 3-4) Hepatobiliary disorders TRAE (grade 3-4) Hypersensitivity TRAE (grade 3-4) Hypertension TRAE (grade 3-4) Hyperthyroidism TRAE (grade 3-4) Hypophysitis TRAE (grade 3-4) Hypothyroidism TRAE (grade 3-4) Increase AST TRAE (grade 3-4) Increased ALT TRAE (grade 3-4) Infusion-related reactions TRAE (grade 3-4) Leucopenia TRAE (grade 3-4) Maculopapular rash TRAE (grade 3-4) Metabolism and nutrition disorders TRAE (grade 3-4) Mucosal inflammation TRAE (grade 3-4) Musculoskeletal and connective tissue disorders TRAE (grade 3-4) Myalgia TRAE (grade 3-4) Myocarditis TRAE (grade 3-4) Myositis TRAE (grade 3-4) Nausea TRAE (grade 3-4) Nephritis TRAE (grade 3-4) Nervous system disorders TRAE (grade 3-4) Neutropenia TRAE (grade 3-4) Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) Pancreatitis TRAE (grade 3-4) Pancytopenia TRAE (grade 3-4) Paraesthesia TRAE (grade 3-4) Peripheral oedema TRAE (grade 3-4) Pneumonitis TRAE (grade 3-4) Pruritic rash TRAE (grade 3-4) Pruritus generalised TRAE (grade 3-4) Pruritus TRAE (grade 3-4) Pyrexia TRAE (grade 3-4) Rash TRAE (grade 3-4) Renal and urinary disorders TRAE (grade 3-4) Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) Sepsis TRAE (grade 3-4) Severe skin reaction TRAE (grade 3-4) Skin and subcutaneous tissue disorders TRAE (grade 3-4) Skin exfoliation TRAE (grade 3-4) Stevens-Johnson syndrome TRAE (grade 3-4) Stomatitis TRAE (grade 3-4) Thrombocytopenia TRAE (grade 3-4) Thyroiditis TRAE (grade 3-4) Uveitis TRAE (grade 3-4) Vascular disorders TRAE (grade 3-4) Vomiting TRAE (grade 3-4) Weight decreased TRAE (grade 3-4) Abdominal pain AE (grade 3-4) Acute kidney injury AE (grade 3-4) Anaemia AE (grade 3-4) Asthenia AE (grade 3-4) Back pain AE (grade 3-4) Blood and lymphatic system disorders AE (grade 3-4) Decreased appetite AE (grade 3-4) Diarrhoea AE (grade 3-4) Dizziness AE (grade 3-4) Dyspnoea AE (grade 3-4) Fatigue AE (grade 3-4) Febrile neutropenia AE (grade 3-4) Gastrointestinal disorders AE (grade 3-4) General disorders and administration site conditions AE (grade 3-4) Hypertension AE (grade 3-4) Hypothyroidism AE (grade 3-4) Increase AST AE (grade 3-4) Leucopenia AE (grade 3-4) Metabolism and nutrition disorders AE (grade 3-4) Mucosal inflammation AE (grade 3-4) Nausea AE (grade 3-4) Nervous system disorders AE (grade 3-4) Neutropenia AE (grade 3-4) Pneumonitis AE (grade 3-4) Rash AE (grade 3-4) Renal and urinary disorders AE (grade 3-4) Respiratory, thoracic and mediastinal disorders AE (grade 3-4) Sepsis AE (grade 3-4) Skin and subcutaneous tissue disorders AE (grade 3-4) Stomatitis AE (grade 3-4) Thrombocytopenia AE (grade 3-4) Vascular disorders AE (grade 3-4) Vomiting AE (grade 3-4) Weight decreased AE (grade 3-4)
numeric
bar chart
forest plot
medians
frequency on treatment
benefit risk analysis
Study
study type
Pathology T1 T0 Patients sample sizes ROB
Results
KEYNOTE-048 (P vs C ; all population), 2019 NCT02358031 RCT mHNSCC - L1 - all population pembrolizumab cetuximab with chemotherapy (platine plus 5FU) patients with recurrent or metastatic squamous cell carcinoma of the head and neck, untreated locally incurable recurrent or metastatic HNSCC 301 / 300 some concern inconclusive suggested 17 % decrease in deaths (OS) (PE) statistically significant 34 % increase in progression or deaths (PFS) (PE) statistically significant 64 % decrease in objective responses (ORR) KEYNOTE-048 (P vs C ; CPS > 20), 2019 NCT02358031 RCT mHNSCC - L1 - PDL1 positive pembrolizumab cetuximab with chemotherapy (platine plus 5FU) patients with recurrent or metastatic squamous cell carcinoma of the head and neck, untreated locally incurable recurrent or metastatic HNSCC 133 / 122 some concern conclusif demonstrated 39 % decrease in deaths (OS) (PE) inconclusive 1 % decrease in progression or deaths (PFS) (PE) suggested 42 % decrease in deaths (OS) (extension) statistically significant 89 % decrease in objective responses (ORR) KEYNOTE-048 (P vs C ; CPS > 1), 2019 NCT02358031 RCT mHNSCC - L1 - PDL1 positive pembrolizumab platinium based chemotherapy (cetuximab plus 5FU and platine) patients with recurrent or metastatic squamous cell carcinoma of the head and neck, untreated locally incurable recurrent or metastatic HNSCC 257 / 255 some concern conclusif demonstrated 22 % decrease in deaths (OS) (PE) inconclusive 16 % increase in progression or deaths (PFS) (PE) suggested 26 % decrease in deaths (OS) (extension) statistically significant 56 % decrease in objective responses (ORR) KEYNOTE-040 (all population), 2018 NCT02252042 RCT mHNSCC - L2 - all population pembrolizumab chemotherapy (methotrexate, docetaxel or cetuximab) patients with recurrent or metastatic head and neck squamous cell cancer that progressed during or after platinum-containing treatment : all population 247 / 248 some concern conclusif demonstrated 20 % decrease in deaths (OS) (PE) KEYNOTE-040 (CPS >1), 2018 NCT02252042 RCT mHNSCC - L2 - PDL1 positive pembrolizumab chemotherapy (methotrexate, docetaxel or cetuximab) patients with recurrent or metastatic head and neck squamous cell cancer that progressed during or after platinum-containing treatment : only patients with CPS > 1 196 / 191 some concern conclusif demonstrated 26 % decrease in deaths (OS) (PE)