PMID- 30584320
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220330
IS  - 1178-6930 (Print)
IS  - 1178-6930 (Electronic)
IS  - 1178-6930 (Linking)
VI  - 11
DP  - 2018
TI  - Efficacy and safety of bevacizumab-based combination therapy for treatment of 
      patients with metastatic colorectal cancer.
PG  - 8605-8621
LID - 10.2147/OTT.S171724 [doi]
AB  - AIM: The use of bevacizumab in combination therapy is an emerging trend in 
      metastatic colorectal cancer treatment. However, the clinical value of different 
      combination types remains under debate. Thus, a meta-analysis of randomized 
      controlled trials (RCTs) comparing bevacizumab-based combination therapy with 
      monotherapy (therapy that uses one type of treatment, such as chemotherapy or 
      surgery alone, to treat metastatic colorectal cancer) was performed, aiming to 
      evaluate the safety and efficacy of bevacizumab-based combination therapy and to 
      find a more beneficial combination. METHODS: We searched for clinical studies 
      that evaluated bevacizumab-based combination therapy in metastatic colorectal 
      cancer. We extracted data from these studies to evaluate the relative risk (RR) 
      of overall response rate (ORR) and grade 3/4 treatment-related adverse events 
      (AEs), HRs of overall survival (OS), and progression-free survival (PFS). 
      RESULTS: Eight RCTs were identified (n=3,424). Treatments included combinations 
      of bevacizumab and oxaliplatin, fluorouracil, and leucovorin (FOLFOX4), 
      combinations of bevacizumab and capecitabine and oxaliplatin, combinations of 
      bevacizumab and fluorouracil/leucovorin, combinations of bevacizumab and 
      irinotecan, fluorouracil, and leucovorin (IFL), and combinations of bevacizumab 
      and capecitabine. Bevacizumab-based combination therapy showed higher ORR (RR: 
      1.40; 95% CI: 1.10-1.78; P=0.005), PFS (HR: 0.64; 95% CI: 0.55-0.73; P=0.000), 
      and OS (HR: 0.82; 95% CI: 0.73-0.92; P=0.001) values than monotherapy. However, 
      higher grade 3/4 treatment-related AEs (RR: 1.27; 95% CI: 1.15-1.41; P=0.000) 
      were observed in combination therapy than in monotherapy. CONCLUSION: This 
      meta-analysis showed that the addition of IFL to bevacizumab better benefits PFS 
      and safety. Adding FOLFOX4 was associated with better ORR and OS. The efficacy 
      and safety of an IFL-bevacizumab-FOLFOX4 combination should be given greater 
      weight in future clinical trials, guidelines, and clinical practice.
FAU - Xu, Ran
AU  - Xu R
AD  - Medical School of Nantong University, Jiangsu 226001, China, ranxu1996@163.com.
AD  - Huai'an Key Laboratory of Gastrointestinal Cancer, Jiangsu 223001, China, 
      ranxu1996@163.com.
FAU - Xu, Chen
AU  - Xu C
AD  - Medical School of Nantong University, Jiangsu 226001, China, ranxu1996@163.com.
FAU - Liu, Chuntong
AU  - Liu C
AD  - XuZhou Medical University, Jiangsu 221000, China.
FAU - Cui, Can
AU  - Cui C
AD  - Macau University of Science and Technology, Macau 519020, China.
FAU - Zhu, Jing
AU  - Zhu J
AD  - Department of Oncology, The Affiliated Huaian NO 1 People's Hospital of Nanjing 
      Medical University, Jiangsu 223001, China, zhujingbiology@163.com.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20181204
PL  - New Zealand
TA  - Onco Targets Ther
JT  - OncoTargets and therapy
JID - 101514322
PMC - PMC6287670
OTO - NOTNLM
OT  - bevacizumab
OT  - combination therapy
OT  - meta-analysis
OT  - metastatic colorectal cancer
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2018/12/26 06:00
MHDA- 2018/12/26 06:01
PMCR- 2018/12/04
CRDT- 2018/12/26 06:00
PHST- 2018/12/26 06:00 [entrez]
PHST- 2018/12/26 06:00 [pubmed]
PHST- 2018/12/26 06:01 [medline]
PHST- 2018/12/04 00:00 [pmc-release]
AID - ott-11-8605 [pii]
AID - 10.2147/OTT.S171724 [doi]
PST - epublish
SO  - Onco Targets Ther. 2018 Dec 4;11:8605-8621. doi: 10.2147/OTT.S171724. eCollection 
      2018.