Efficacy and safety of third-line or later-line targeted treatment for patients with metastatic colorectal cancer: a meta-analysis.
Efficacy and safety of third-line or later-line targeted treatment for patients with metastatic colorectal cancer: a meta-analysis.
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DOI：
10.3389/fonc.2023.1165040
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发表时间：
2023
影响因子：
4.7
通讯作者：
Yang, Wen-Hui
中科院分区：
文献类型：
--
作者：
Xue, Wen-Hui;Li, Xue-Wei;Ding, Ya-Qian;Wu, Na;Pei, Bei-Bei;Ma, Xiao-Yan;Xie, Jun;Yang, Wen-Hui
靶向治疗已在转移性结直肠癌（mCRC）的一线治疗中标准化，而三线或更高线的明确建议仍然缺乏。本研究通过荟萃分析评价靶向治疗联合化疗在三线及以后治疗mCRC中的有效性和安全性，为临床或研究实践提供循证指导。根据PRISMA指南进行相关研究的全面检索。根据患者特征和药物的药理学分类对研究进行分层。对于可用于定量分析的数据，计算汇总的总缓解率、疾病控制率、总生存期（OS）和无进展生存期（PFS）的风险比（HR）以及不良事件发生率及其95%置信区间（CI）。本荟萃分析共纳入22项研究（1，866例患者）。从涉及表皮生长因子受体（EGFR）和血管内皮生长因子（VEGF）靶点的17项研究（1，769例患者）中提取数据进行荟萃分析。单药治疗和联合治疗的总体缓解率分别为4%（95%CI：3%，5%）和20%（95%CI：11%，29%）。OS和PFS的汇总HR（联合治疗vs.单药治疗）分别为0. 72（95% CI：0. 53，0. 99）和0. 34（95% CI：0. 26，0. 45）。另外5项研究纳入叙述描述，涉及BRAF、HER-2、ROS 1和NTRK的靶点。这项荟萃分析的结果表明，VEGF和EGFR抑制剂在治疗mCRC中表现出有希望的临床缓解率和延长的生存期，不良事件可接受。
Targeted therapy has been standardized in front-line therapies for metastatic colorectal cancer (mCRC), while explicit recommendations for third- or later-line are still lacking. This study evaluated the efficacy and safety of combining targeted therapy with chemotherapy in the third- or later-line treatment for mCRC via meta-analysis, providing evidence-based guidance for clinical or research practice. Comprehensive retrieval of related studies was conducted according to the PRISMA guideline. Studies were stratified with patient characteristics and pharmacological classification of the drugs. For the data available for quantitative analysis, pooled overall response rate, disease control rate, hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and adverse events rate with respective 95% confidence intervals (CIs) were calculated. A total of 22 studies (1,866 patients) were included in this meta-analysis. Data from 17 studies (1,769 patients) involving targets of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) were extracted for meta-analyses. The overall response rates for monotherapy and combined therapy were 4% (95% CI: 3%, 5%) and 20% (95% CI: 11%, 29%). The pooled HRs (combined therapy vs. mono) for OS and PFS were 0.72 (95% CI: 0.53, 0.99) and 0.34 (95% CI: 0.26, 0.45). Another five studies were included in narrative depiction, involving targets of BRAF, HER-2, ROS1, and NTRK. The findings of this meta-analysis indicate that VEGF and EGFR inhibitors manifest promising clinical response rates and prolonged survival in the treatment of mCRC with acceptable adverse events.
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DOI：
10.6004/jnccn.2018.0061
发表时间：
2018-07
期刊：
Journal of the National Comprehensive Cancer Network : JNCCN
影响因子：
--
作者：
Benson AB;Venook AP;Al-Hawary MM;Cederquist L;Chen YJ;Ciombor KK;Cohen S;Cooper HS;Deming D;Engstrom PF;Grem JL;Grothey A;Hochster HS;Hoffe S;Hunt S;Kamel A;Kirilcuk N;Krishnamurthi S;Messersmith WA;Meyerhardt J;Mulcahy MF;Murphy JD;Nurkin S;Saltz L;Sharma S;Shibata D;Skibber JM;Sofocleous CT;Stoffel EM;Stotsky-Himelfarb E;Willett CG;Wuthrick E;Gregory KM;Gurski L;Freedman-Cass DA
通讯作者：
Freedman-Cass DA
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
29.4
作者：
Kahi, Charles J.;Boland, C. Richard;Rex, Douglas K.
通讯作者：
Rex, Douglas K.
影响因子：
3.4
作者：
Akiyoshi, Kohei;Hamaguchi, Tetsuya;Shimada, Yasuhiro
通讯作者：
Shimada, Yasuhiro
影响因子：
5.8
作者：
Chen, Xiaofeng;Qiu, Tianzhu;Gu, Yanhong
通讯作者：
Gu, Yanhong