PMID- 34554888
OWN - NLM
STAT- MEDLINE
DCOM- 20220113
LR  - 20220113
IS  - 1526-2359 (Electronic)
IS  - 1073-2748 (Print)
IS  - 1073-2748 (Linking)
VI  - 28
DP  - 2021 Jan-Dec
TI  - Network Meta-analysis of First-Line Systemic Treatment for Patients With 
      Metastatic Colorectal Cancer.
PG  - 10732748211033497
LID - 10.1177/10732748211033497 [doi]
LID - 10732748211033497
AB  - PURPOSE: To assess the relative efficacy and safety of first-line systemic 
      therapies in patients with metastatic colorectal cancer. EXPERIMENTAL DESIGN: A 
      comprehensive literature review was conducted including MEDLINE, Embase, and the 
      Cochrane Central Registry of Controlled Trials for phase II or III randomized 
      controlled trials (RCTs) published up to and including July 15, 2019. We included 
      RCTs in which at least 1 intervention was either chemotherapeutic agents (such as 
      fluorouracil, irinotecan, or oxaliplatin) or antibodies targeting angiogenesis 
      (such as bevacizumab) or agents that act on the epidermal growth factor receptor 
      pathway (such as cetuximab and panitumumab) or studies reported at least one of 
      the following outcomes: overall survival (OS), progression-free survival (PFS), 
      and/or Grade 3 + adverse events (AEs). Using a random effect model, we performed 
      a Bayesian network meta-analysis to analyze the probability of optimal 
      therapeutic regime obtained from direct comparisons with indirect evidences. We 
      estimated hazard ratios for OS and PFS. RESULTS: A total of 30 RCTs comprising 
      12,146 mCRC patients with 25 different treatment strategies were included. The 
      triple combination FOLFOXIRI [fluorouracil, leucovorin, oxaliplatin, and 
      irinotecan] plus bevacizumab provided significant survival benefits with improved 
      OS over all other treatments. The network meta-analysis also indicated a 
      significant advantage of using FOLFOXIRI plus bevacizumab in comparison to other 
      treatment strategies for PFS. Besides, FOLFOXIRI plus bevacizumab was associated 
      with the well-tolerated adverse events. CONCLUSIONS: Our study supported the use 
      of FOLFOXIRI plus bevacizumab as the best first-line regimen and potentially 
      effective and safe strategy for the management of patients with mCRC.
FAU - Xu, Shan
AU  - Xu S
AUID- ORCID: 0000-0003-0754-0969
AD  - Department of Radiotherapy, University Hospital Essen, Germany.
FAU - Sak, Ali
AU  - Sak A
AD  - Department of Radiotherapy, University Hospital Essen, Germany.
FAU - Erol, Yasin Bahadir
AU  - Erol YB
AD  - Department of Radiotherapy, University Hospital Essen, Germany.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Cancer Control
JT  - Cancer control : journal of the Moffitt Cancer Center
JID - 9438457
RN  - 0 (Antineoplastic Agents, Immunological)
SB  - IM
MH  - Antineoplastic Agents, Immunological/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Clinical Trials, Phase II as Topic
MH  - Clinical Trials, Phase III as Topic
MH  - Colorectal Neoplasms/*drug therapy/mortality/*pathology
MH  - Humans
MH  - Interatrial Block
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - Survival Analysis
PMC - PMC8474314
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/09/24 06:00
MHDA- 2022/01/14 06:00
PMCR- 2021/09/23
CRDT- 2021/09/23 17:16
PHST- 2021/09/23 17:16 [entrez]
PHST- 2021/09/24 06:00 [pubmed]
PHST- 2022/01/14 06:00 [medline]
PHST- 2021/09/23 00:00 [pmc-release]
AID - 10.1177_10732748211033497 [pii]
AID - 10.1177/10732748211033497 [doi]
PST - ppublish
SO  - Cancer Control. 2021 Jan-Dec;28:10732748211033497. doi: 
      10.1177/10732748211033497.