Efficacy of chemotherapy plus bevacizumab as first-line therapy in patients with metastatic colorectal cancer: a meta-analysis and up-date

被引:1
作者
Zhang, Guoliang [1 ]
Zhou, Xile [1 ]
Lin, Caizhao [1 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Colorectal Surg, Hangzhou 310003, Zhejiang, Peoples R China
来源
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE | 2015年 / 8卷 / 01期
关键词
Metastatic colorectal cancer; bevacizumab; chemotherapy; meta-analysis; RANDOMIZED PHASE-III; FLUOROURACIL; LEUCOVORIN; OXALIPLATIN; SAFETY; COMBINATION; IRINOTECAN; CAPECITABINE; TRIAL; CETUXIMAB;
D O I
暂无
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Colorectal cancer (CRC) is a major cause of cancer morbidity and mortality worldwide. Bevacizumab plays an important role in the treatment of metastatic CRC (mCRC). The aim of this study was to evaluate the efficacy and safety of chemotherapy plus bevacizumab as first-line treatment in patients with mCRC. Randomized-controlled clinical trials comparing the efficacy of chemotherapy plus bevacizumab or chemotherapy alone in patients with mCRC were searched using the following electronic database of PubMed, Medline, Embase and CNKI. Total 9 trials, containing 1843 patients in chemotherapy plus bevacizumab group and 1741 patients in chemotherapy alone group, were included. Our results showed that chemotherapy plus bevacizumab statistically increased the Overall response rate (ORR) in patients with mCRC (OR = 1.57, 95% CI = 1.17-2.11, P = 0.003) in a random-effects model. The complete response rate and partial response rate were statistically increased as well (P = 0.05). Subgroup analysis by bevacizumab dosage found that bevacizumab 5 mg/kg statistically increased the ORR. Significant differences were found in PFS (HR = 0.56, 95% CI = 0.46-0.69, P < 0.00001) and OS (HR = 0.83, 95% CI = 0.76-0.91, P < 0.0001) as well. No significant difference was found in adverse events. Overall, the combination of chemotherapy and bevacizumab as first-line treatment is an effective and well-tolerated regimen for patients with mCRC.
引用
收藏
页码:1434 / 1445
页数:12
相关论文
共 38 条
[1]   Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer [J].
Amado, Rafael G. ;
Wolf, Michael ;
Peeters, Marc ;
Van Cutsem, Eric ;
Siena, Salvatore ;
Freeman, Daniel J. ;
Juan, Todd ;
Sikorski, Robert ;
Suggs, Sid ;
Radinsky, Robert ;
Patterson, Scott D. ;
Chang, David D. .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (10) :1626-1634
[2]  
[Anonymous], COMPLEXITIES COLOREC
[3]   Bevacizumab (BEV) plus chemotherapy (CT) continued beyond first progression in patients with metastatic colorectal cancer (mCRC) previously treated with BEV plus CT: Results of a randomized phase III intergroup study (TML study). [J].
Arnold, Dirk ;
Andre, Thierry ;
Bennouna, Jaafar ;
Sastre, Javier ;
Osterlund, Pia J. ;
Greil, Richard ;
Van Cutsem, Eric ;
Von Moos, Roger ;
Reyes-Rivera, Irmarie ;
Bendahmane, Belguendouz ;
Kubicka, Stefan .
JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (15)
[4]   Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial [J].
Bennouna, Jaafar ;
Sastre, Javier ;
Arnold, Dirk ;
Osterlund, Pia ;
Greil, Richard ;
Van Cutsem, Eric ;
von Moos, Roger ;
Maria Vieitez, Jose ;
Bouche, Olivier ;
Borg, Christophe ;
Steffens, Claus-Christoph ;
Alonso-Orduna, Vicente ;
Schlichting, Christoph ;
Reyes-Rivera, Irmarie ;
Bendahmane, Belguendouz ;
Andre, Thierry ;
Kubicka, Stefan .
LANCET ONCOLOGY, 2013, 14 (01) :29-37
[5]   RIBBON-2: A Randomized, Double-Blind, Placebo-Controlled, Phase III Trial Evaluating the Efficacy and Safety of Bevacizumab in Combination With Chemotherapy for Second-Line Treatment of Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer [J].
Brufsky, Adam M. ;
Hurvitz, Sara ;
Perez, Edith ;
Swamy, Raji ;
Valero, Vicente ;
O'Neill, Vincent ;
Rugo, Hope S. .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (32) :4286-4293
[6]   A meta-analysis of randomized controlled trials comparing chemotherapy plus bevacizumab with chemotherapy alone in metastatic colorectal cancer [J].
Cao, Yunfei ;
Tan, Aihua ;
Gao, Feng ;
Liu, Lidan ;
Liao, Cun ;
Mo, Zengnan .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2009, 24 (06) :677-685
[7]  
Cooper K, 2010, HEALTH TECHNOL ASSES, V14, P1, DOI [10.3310/hta14320, 10.3310/hta.14320]
[8]   Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial [J].
Cunningham, David ;
Lang, Istvan ;
Marcuello, Eugenio ;
Lorusso, Vito ;
Ocvirk, Janja ;
Shin, Dong Bok ;
Jonker, Derek ;
Osborne, Stuart ;
Andre, Niko ;
Waterkamp, Daniel ;
Saunders, Mark P. .
LANCET ONCOLOGY, 2013, 14 (11) :1077-1085
[9]   Safety of Bevacizumab in Treating Metastatic Colorectal Cancer: A Systematic Review and Meta-analysis of All Randomized Clinical Trials [J].
Dai, Fei ;
Shu, Lixing ;
Bian, Yangfang ;
Wang, Zhuo ;
Yang, Zhangwei ;
Chu, Wengong ;
Gao, Shen .
CLINICAL DRUG INVESTIGATION, 2013, 33 (11) :779-788
[10]   Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer [J].
de Gramont, A ;
Figer, A ;
Seymour, M ;
Homerin, M ;
Hmissi, A ;
Cassidy, J ;
Boni, C ;
Cortes-Funes, H ;
Cervantes, A ;
Freyer, G ;
Papamichael, D ;
Le Bail, N ;
Louvet, C ;
Hendler, D ;
de Braud, F ;
Wilson, C ;
Morvan, F ;
Bonetti, A .
JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (16) :2938-2947