PMID- 26171215
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2049-9450 (Print)
IS  - 2049-9469 (Electronic)
IS  - 2049-9450 (Linking)
VI  - 3
IP  - 4
DP  - 2015 Jul
TI  - Vascular endothelial growth factor receptor tyrosine kinase inhibitors versus 
      bevacizumab in metastatic colorectal cancer: A systematic review and 
      meta-analysis.
PG  - 959-967
AB  - Bevacizumab has demonstrated a survival benefit in patients with metastatic 
      colorectal cancer (mCRC) when combined with chemotherapy. Several randomized 
      clinical trials comparing the efficacy and toxicity of vascular endothelial 
      growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) against 
      bevacizumab have been reported. The present meta-analysis was conducted to 
      identify the potentially significant benefit of the combined treatment regimens 
      in patients with mCRC. PubMed, Embase and Cochrane Library databases were 
      searched for the randomized controlled trials published on or before September 
      2014, which compared the efficacy and toxicity of VEGFR TKIs with bevacizumab in 
      combination with chemotherapy in patients with mCRC. The primary endpoints 
      included progression-free survival (PFS), overall survival (OS) and overall 
      response rate (ORR), and secondary endpoints were the toxicity profiles. Relative 
      risks (RRs) with 95% confidence intervals (CIs) for response rate and adverse 
      events (AEs) were calculated, as well as hazard ratios (HRs) for PFS and OS. The 
      final analysis included 4 studies comprising a total of 1,929 intent-to-treat 
      patients with mCRC, which compared VEGFR TKIs (cediranib and axitinib) plus 
      chemotherapy with bevacizumab plus chemotherapy. Results demonstrated that VEGFR 
      TKIs plus chemotherapy significantly resulted in a modest but significantly 
      shorter PFS [hazard ratio (HR), 1.12; 95% CI, 1.00-1.25; P=0.05] compared with 
      that of bevacizumab plus chemotherapy but not in OS (HR, 1.10; 95% CI, 0.88-1.17; 
      P=0.87) and ORR (RR, 0.95; 95% CI, 0.85-1.05; P=0.30). VEGFR TKIs treatment 
      showed a less favorable AE profile compared with bevacizumab, with higher rates 
      of grade-III/IV diarrhea, fatigue, hypertension, neutropenia and 
      thrombocytopenia, whereas a higher incidence of peripheral neuropathy associated 
      with the bevacizumab group was observed. In conclusion, the addition of VEGFR 
      TKIs to chemotherapy resulted in a modest but significantly shorter PFS but not 
      in OS and ORR compared with bevacizumab. The VEGFR TKIs group showed a less 
      favorable AE profile with higher rates of diarrhea, fatigue, hypertension, 
      neutropenia and thrombocytopenia, whereas a higher incidence of peripheral 
      neuropathy associated with the bevacizumab was observed.
FAU - Lin, Zexin
AU  - Lin Z
AD  - Department of General Surgery, The First Clinical Medicine School of Jinan 
      University, Affiliated Shantou Hospital of Sun Yat-Sen University, Guangzhou, 
      Guangdong, P.R. China.
FAU - Yang, Yilin
AU  - Yang Y
AD  - Department of General Surgery, The First Clinical Medicine School of Jinan 
      University, Guangzhou, Guangdong, P.R. China.
FAU - Huang, Yongliang
AU  - Huang Y
AD  - Department of General Surgery, The First Clinical Medicine School of Jinan 
      University, Guangzhou, Guangdong, P.R. China.
FAU - Liang, Junjie
AU  - Liang J
AD  - Department of General Surgery, The First Clinical Medicine School of Jinan 
      University, Guangzhou, Guangdong, P.R. China.
FAU - Lu, Fang
AU  - Lu F
AD  - Department of Orthopedics, The First Clinical Medicine School of Jinan 
      University, Guangzhou, Guangdong, P.R. China.
FAU - Lao, Xuejun
AU  - Lao X
AD  - Department of General Surgery, The First Affiliated Hospital of Jinan University, 
      Guangzhou, Guangdong, P.R. China.
LA  - eng
PT  - Journal Article
DEP - 20150515
PL  - England
TA  - Mol Clin Oncol
JT  - Molecular and clinical oncology
JID - 101613422
PMC - PMC4486826
OTO - NOTNLM
OT  - advanced or metastatic colorectal cancer
OT  - bevacizumab
OT  - chemotherapy
OT  - meta-analysis
OT  - vascular endothelial growth factor receptor tyrosine kinase inhibitor
EDAT- 2015/07/15 06:00
MHDA- 2015/07/15 06:01
PMCR- 2015/05/15
CRDT- 2015/07/15 06:00
PHST- 2015/01/29 00:00 [received]
PHST- 2015/04/24 00:00 [accepted]
PHST- 2015/07/15 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2015/07/15 06:01 [medline]
PHST- 2015/05/15 00:00 [pmc-release]
AID - MCO-0-0-572 [pii]
AID - 10.3892/mco.2015.572 [doi]
PST - ppublish
SO  - Mol Clin Oncol. 2015 Jul;3(4):959-967. doi: 10.3892/mco.2015.572. Epub 2015 May 
      15.