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

Purpose To gain a better understanding of the incidence and risk of hypokalemia in patients who received cetuximabbased therapy. Patients and methods 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/m2 weekly thereafter. The primary endpoint was incidence of hypokalemia. Results 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, cetuximabbased therapy has higher risk of grade 3 and 4 hypokalemia [1.81 (95% CI 1.12-2.93)]. Conclusion Cetuximab-based therapy is associated with a signiWcant risk of hypokalemia. Early monitoring and effective management of hypokalemia is important for patients that received cetuximab-based therapy.