PMID- 35223449
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230917
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 11
DP  - 2021
TI  - Efficacy and Safety of Systemic Treatments Among Colorectal Cancer Patients: A 
      Network Meta-Analysis of Randomized Controlled Trials.
PG  - 756214
LID - 10.3389/fonc.2021.756214 [doi]
LID - 756214
AB  - BACKGROUND: Systemic treatments, namely, either monotherapy or combination 
      therapy, are commonly administered to patients with advanced or metastatic 
      colorectal cancer (CRC). This study aimed to provide the complete efficacy and 
      safety profiles and ranking of systemic therapies for the treatment of 
      unresectable advanced or metastatic CRC. METHODS: We searched PubMed, Embase, the 
      Cochrane Library, and ClinicalTrials.gov from inception until June 30, 2021, and 
      also the bibliographies of relevant studies. Randomized controlled trials 
      comparing two or more treatments, namely, at least capecitabine, 5-fluorouracil, 
      leucovorin, irinotecan, bevacizumab, cetuximab, oxaliplatin, or panitumumab were 
      investigated. A network meta-analysis using the Bayesian approach was performed 
      to compare the efficacy and safety of treatments. The surface under the 
      cumulative ranking curve (SUCRA) was calculated for the probability of each 
      treatment as the most effective. The overall response rate (ORR), disease control 
      rate (DCR), overall survival (OS), progression-free survival (PFS), adverse 
      events (AEs) grade >/=3, and serious adverse events (SAEs) were evaluated. RESULTS: 
      One hundred two publications with 36,147 participants were assigned to 39 
      different treatments. Among 11 treatments with full information on six outcomes, 
      FOLFIRI/FOLFOX/FOLFOXIRI + bevacizumab significantly improved both the ORR and 
      DCR, compared to FOLFIRI. Although FOLFOX and FOLFIRI/FOLFOX + cetuximab 
      significantly prolonged both OS and PFS, treatments were comparable in terms of 
      AEs grade >/=3 and SAEs. The top highest SUCRA values were observed in the 
      FOLFOXIRI + panitumumab group for ORR (96%) and DCR (99%), FOLFIRI + bevacizumab 
      + panitumumab group for OS (62%) and PFS (54%), and FOLFOXIRI + bevacizumab group 
      for AEs grade >/=3 (59%) and SAEs (59%) outcomes. CONCLUSIONS: These findings 
      suggest an available range of systemic treatment therapies with different 
      efficacy and safety profiles with patients. Further investigations of the side 
      effects and mutation status are required to confirm our findings. SYSTEMATIC 
      REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier 
      CRD42019127772.
CI  - Copyright (c) 2022 Hoang, Sohn, Kim, Cha and Kim.
FAU - Hoang, Tung
AU  - Hoang T
AD  - Department of Cancer Biomedical Science, National Cancer Center Graduate School 
      of Cancer Science and Policy, Goyang, South Korea.
FAU - Sohn, Dae Kyung
AU  - Sohn DK
AD  - Center for Colorectal Cancer, Research Institute and Hospital, National Cancer 
      Center, Goyang, South Korea.
FAU - Kim, Byung Chang
AU  - Kim BC
AD  - Center for Colorectal Cancer, Research Institute and Hospital, National Cancer 
      Center, Goyang, South Korea.
FAU - Cha, Yongjun
AU  - Cha Y
AD  - Center for Colorectal Cancer, Research Institute and Hospital, National Cancer 
      Center, Goyang, South Korea.
FAU - Kim, Jeongseon
AU  - Kim J
AD  - Department of Cancer Biomedical Science, National Cancer Center Graduate School 
      of Cancer Science and Policy, Goyang, South Korea.
LA  - eng
PT  - Systematic Review
DEP - 20220209
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC8864322
OTO - NOTNLM
OT  - chemotherapy
OT  - colorectal cancer
OT  - metastasis
OT  - network meta-analysis
OT  - targeted therapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/03/01 06:00
MHDA- 2022/03/01 06:01
PMCR- 2021/01/01
CRDT- 2022/02/28 05:38
PHST- 2021/08/19 00:00 [received]
PHST- 2021/12/31 00:00 [accepted]
PHST- 2022/02/28 05:38 [entrez]
PHST- 2022/03/01 06:00 [pubmed]
PHST- 2022/03/01 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2021.756214 [doi]
PST - epublish
SO  - Front Oncol. 2022 Feb 9;11:756214. doi: 10.3389/fonc.2021.756214. eCollection 
      2021.