PMID- 33541293
OWN - NLM
STAT- MEDLINE
DCOM- 20210510
LR  - 20210510
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Feb 4
TI  - Comparison of irinotecan and oxaliplatin as the first-line therapies for 
      metastatic colorectal cancer: a meta-analysis.
PG  - 116
LID - 10.1186/s12885-021-07823-7 [doi]
LID - 116
AB  - BACKGROUND: Irinotecan (IRI) and oxaliplatin (Ox) are standard therapeutic agents 
      of the first-line treatments for metastatic colorectal cancer (mCRC). Previous 
      meta-analyses of randomized controlled trials (RCTs) showed that treatment with 
      Ox-based compared with IRI-based regimens was associated with better overall 
      survival (OS). However, these reports did not include trials of molecular 
      targeting agents and did not take methods for the administration of concomitant 
      drugs, such as bolus or continuous infusion of 5-fluorouracil, into account. A 
      systematic literature review was performed to compare the efficacy and toxicity 
      profiles between IRI- and Ox-based regimens as the first-line treatments for 
      mCRC. METHODS: This meta-analysis used data from the Cochrane Central Register of 
      Controlled Trials, PubMed, and SCOPUS. The primary endpoint was OS, and the 
      secondary endpoints were progression-free survival (PFS), objective response rate 
      (ORR), and adverse events (AEs). RESULTS: Nineteen trials involving 4571 patients 
      were included in the analysis. No statistically significant difference was 
      observed between the two groups in terms of OS, PFS, and ORR. There was no 
      significant heterogeneity. Regarding >/= grade 3 AEs, IRI-based regimens were 
      associated with a high incidence of leukopenia, febrile neutropenia, and 
      diarrhea. Moreover, there was a high incidence of thrombocytopenia and peripheral 
      sensory neuropathy in patients who received Ox-based regimens. In a subgroup 
      analysis, IRI combined with bevacizumab was correlated with a better PFS 
      (HR = 0.90, 95% CI = 0.82-0.98, P = 0.02), but not with OS (pooled HR = 0.91, 95% 
      CI = 0.80-1.03, P = 0.15). CONCLUSION: Although the safety profiles of IRI- and 
      Ox-based regimens varied, their efficacy did not significantly differ. The 
      combination of anti-VEGF antibody and IRI was associated with better PFS compared 
      with anti-VEGF antibody and Ox. Both regimens could be used as the first-line 
      treatments for mCRC with consideration of the patients' condition or toxicity 
      profiles.
FAU - Kawai, Sadayuki
AU  - Kawai S
AUID- ORCID: 0000-0001-6815-6261
AD  - Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 
      Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka, 411-8777, Japan. 
      sadayuki-kawai@i.shizuoka-pho.jp.
AD  - Department of Medical Oncology, Shizuoka General Hospital, 4-27-1 Kita ando, 
      Aoi-ku, Shizuoka City, 420-8527, Japan. sadayuki-kawai@i.shizuoka-pho.jp.
FAU - Takeshima, Nozomi
AU  - Takeshima N
AD  - Department of Psychiatry, Kitabayashi Hospital, 7-58 Nakamura-cho, Nakamura-ku, 
      Nagoya, Aichi, 453-0053, Japan.
FAU - Hayasaka, Yu
AU  - Hayasaka Y
AD  - Department of Psychiatry, Tsukuba Psychosomatics Clinic, 5-12-4, Kenkyu-gakuen, 
      Tsukuba, Ibaraki, 305-0817, Japan.
FAU - Notsu, Akifumi
AU  - Notsu A
AD  - Clinical Research Center, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, 
      Sunto-gun, Shizuoka, 411-8777, Japan.
FAU - Yamazaki, Mutsumi
AU  - Yamazaki M
AD  - Information Management Office, Shizuoka Cancer Center, 1007 Shimonagakubo, 
      Nagaizumi, Sunto-gun, Shizuoka, 411-8777, Japan.
FAU - Kawabata, Takanori
AU  - Kawabata T
AD  - Clinical Research Center, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, 
      Sunto-gun, Shizuoka, 411-8777, Japan.
FAU - Yamazaki, Kentaro
AU  - Yamazaki K
AD  - Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 
      Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka, 411-8777, Japan.
FAU - Mori, Keita
AU  - Mori K
AD  - Clinical Research Center, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, 
      Sunto-gun, Shizuoka, 411-8777, Japan.
FAU - Yasui, Hirofumi
AU  - Yasui H
AD  - Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 
      Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka, 411-8777, Japan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210204
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 04ZR38536J (Oxaliplatin)
RN  - 7673326042 (Irinotecan)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Colorectal Neoplasms/*drug therapy/pathology
MH  - Humans
MH  - Irinotecan/administration & dosage
MH  - Oxaliplatin/administration & dosage
MH  - Prognosis
MH  - Systematic Reviews as Topic
PMC - PMC7863255
OTO - NOTNLM
OT  - Chemotherapy
OT  - Meta-analysis
OT  - Metastatic colorectal cancer
COIS- All authors declare no conflicts-of-interest related to this article.
EDAT- 2021/02/06 06:00
MHDA- 2021/05/11 06:00
PMCR- 2021/02/04
CRDT- 2021/02/05 05:38
PHST- 2020/09/02 00:00 [received]
PHST- 2021/01/20 00:00 [accepted]
PHST- 2021/02/05 05:38 [entrez]
PHST- 2021/02/06 06:00 [pubmed]
PHST- 2021/05/11 06:00 [medline]
PHST- 2021/02/04 00:00 [pmc-release]
AID - 10.1186/s12885-021-07823-7 [pii]
AID - 7823 [pii]
AID - 10.1186/s12885-021-07823-7 [doi]
PST - epublish
SO  - BMC Cancer. 2021 Feb 4;21(1):116. doi: 10.1186/s12885-021-07823-7.