The prognostic role of BRAF mutation in metastatic colorectal cancer receiving anti-EGFR monoclonal antibodies: a meta-analysis.
The prognostic role of BRAF mutation in metastatic colorectal cancer receiving anti-EGFR monoclonal antibodies: a meta-analysis.
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BRAF 突变在接受抗 EGFR 单克隆抗体的转移性结直肠癌中的预后作用：荟萃分析
DOI：
10.1371/journal.pone.0065995
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Wang JP
中科院分区：
文献类型：
--
作者：
Yuan ZX;Wang XY;Qin QY;Chen DF;Zhong QH;Wang L;Wang JP
BRAF突变已被研究为转移性结直肠癌(MCRC)接受抗EGFR单抗(MoAbs)治疗的预后因素，但目前的结果仍不确定。这项荟萃分析的目的是评估BRAF突变状态与接受moAbbs治疗的mCRC患者预后的关系。通过系统地搜索Pubmed、Cochrane图书馆、知识网和Ovid来确定符合条件的研究。提取或计算总有效率(ORR)的风险比(RR)、无进展生存率(PFS)和总生存率(OS)的危险比(HR)。在KRAS野生型和不同研究类型中进行了预先指定的亚群分析。通过敏感性分析，探讨了试验间变异的来源。根据海登的标准进行质量评估。共有21项试验，包括5229名患者被确定用于荟萃分析。在已知BRAF状态的4616例(7.4%)患者中，有343例出现BRAF突变。与BRAF突变体相比，BRAF野生型(WT)患者的进展和死亡风险降低，PFS改善(HR 0.38，95%可信区间0.29-0.51)，OS改善(HR 0.35[0.29-0.42])。在KRAS WT人群中，BRAF WT有更大的PFS收益(HR 0.29[0.19，0.43])和更大的OS收益(HR 0.26[0.20，0.35])。在KRAS WT患者中观察到BRAF WT的应答益处(RR 0.31[0.18，0.53])，但在未选择的患者中未观察到(RR 0.76[0.43-1.33])。不同研究类型的亚组分析结果一致。试验之间的异质性在亚组中降低，并通过敏感性分析解释。未检测到ORR、PFS和OS的发表偏倚。结果表明，BRAF突变是接受抗EGFR MoAbs治疗的mCRC患者，尤其是KRAS WT患者预后不良的预测生物标志物。还需要更多的大型前瞻性试验来确认BRAF地位的预测作用。
BRAF mutation has been investigated as a prognostic factor in metastatic colorectal cancer (mCRC) undergoing anti-EGFR monoclonal antibodies (moAbs), but current results are still inconclusive. The aim of this meta-analysis was to evaluate the relationship between BRAF mutation status and the prognosis of mCRC patients treated with moAbs. Eligible studies were identified by systematically searching Pubmed, the Cochrane Library, Web of Knowledge, and OVID. Risk ratio (RR) for overall response rate (ORR), Hazard ratios (HRs) for Progression free survival (PFS) and Overall survival (OS) were extracted or calculated. Prespecified subgroup analyses were conducted in KRAS wild-type and in different study types. The source of between-trial variation was explored by sensitivity analyses. Quality assessment was conducted by the Hayden’s criteria. A total of twenty one trials including 5229 patients were identified for the meta-analysis. 343 patients displayed BRAF mutations of 4616 (7.4%) patients with known BRAF status. Patients with BRAF wild-type (WT) showed decreased risks of progression and death with an improved PFS(HR 0.38, 95% confidence intervals 0.29–0.51) and an improved OS (HR 0.35 [0.29–0.42]), compared to BRAF mutant. In KRAS WT population, there were even larger PFS benefit (HR 0.29[0.19,0.43]) and larger OS benefit (HR 0.26 [0.20,0.35]) in BRAF WT. A response benefit for BRAF WT was observed (RR 0.31[0.18,0.53]) in KRAS WT patients, but not observed in unselected patients (RR 0.76 [0.43–1.33]). The results were consistent in the subgroup analysis of different study types. Heterogeneity between trials decreased in the subgroup and explained by sensitivity analysis. No publication bias of ORR, PFS and OS were detected. The results indicate that BRAF mutant is a predictive biomarker for poor prognosis in mCRC patients undergoing anti-EGFR MoAbs therapy, especially in KRAS WT patients. Additional large prospective trials are required to confirm the predictive role of BRAF status.
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KRAS密码子61、146和BRAF突变预测KRAS密码子12和13野生型转移性结直肠癌中对西妥昔单抗和伊立替康的抗性。
影响因子：
8.8
作者：
通讯作者：
--
影响因子：
8
作者：
Frattini, M;Ferrario, C;Greco, A
通讯作者：
Greco, A
影响因子：
50.5
作者：
Bokemeyer, C.;Bondarenko, I.;Koralewski, P.
通讯作者：
Koralewski, P.
影响因子：
8.4
作者：
Bokemeyer, Carsten;Van Cutsem, Eric;Koehne, Claus-Henning
通讯作者：
Koehne, Claus-Henning
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N