Bevacizumab improves survival in metastatic colorectal cancer patients with primary tumor resection: A meta-analysis
Bevacizumab improves survival in metastatic colorectal cancer patients with primary tumor resection: A meta-analysis
复制标题
贝伐单抗可提高原发性肿瘤切除的转移性结直肠癌患者的生存率：一项荟萃分析。
DOI：
10.1038/s41598-019-56528-2
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发表时间：
2019-12-30
影响因子：
4.6
通讯作者：
Xu, Ximing
中科院分区：
文献类型：
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作者：
Cao, Dedong;Zheng, Yongfa;Xu, Ximing
对于接受贝伐珠单抗治疗的转移性结直肠癌 (mCRC) 患者，目前尚不清楚原发肿瘤切除是否与更好的预后相关。在这项荟萃分析中，我们旨在评估原发肿瘤切除术对贝伐珠单抗治疗的转移性结直肠癌的预后作用。截至 2018 年 4 月，对包括 Cochrane 图书馆、Embase 和 Pubmed 在内的电子数据库进行了检索。确定了评估原发肿瘤切除对贝伐单抗对 mCRC 患者疗效影响的临床研究。主要终点是总生存期（OS），次要终点是无进展生存期（PFS）。最终纳入了 7 项研究，涉及 2760 名 mCRC 患者。荟萃分析结果显示，就 OS（HR = 0.50，95% CI：0.39-0.64；p < 0.01）和 PFS（HR = 0.65，95% CI：0.51-0.81；p < 0.01）而言，贝伐珠单抗对原发肿瘤切除患者有利。与化疗 (CT) 相比，对原发肿瘤已切除的 mCRC 患者给予贝伐单抗具有更好的 OS（HR = 0.65，95% CI：0.56-0.74；p < 0.01）。与单独化疗相比，在未切除原发肿瘤的 mCRC 患者中添加贝伐珠单抗也具有更好的 OS（HR = 0.78，95%CI：0.65-0.94；p < 0.01）和 PFS（HR = 0.71，95%CI：0.57-0.88；p < 0.01）。总之，使用贝伐珠单抗治疗时，原发肿瘤已切除的转移性结直肠癌患者比原发肿瘤未手术的转移性结直肠癌患者有更好的生存率。在 mCRC 中使用贝伐珠单抗时，应考虑原发肿瘤切除状态。
It is not well determined whether primary tumor resection is associated with better outcomes in metastatic colorectal cancer (mCRC) patients treated with bevacizumab. In this meta-analysis, we aimed to assess the prognostic role of primary tumor resection in mCRC treated with bevacizumab. Electronic databases including the Cochrane library, Embase, and Pubmed were searched until April 2018. Clinical studies assessing the influence of primary tumor resection on the efficacy of bevacizumab in patients with mCRC were identified. The primary endpoint was overall survival (OS), and the secondary endpoint was progression-free survival (PFS). Seven studies including 2760 mCRC patients were finally included. The results of the meta-analysis were in favor of bevacizumab to patients with resected primary tumor in terms of OS (HR = 0.50, 95%CI: 0.39-0.64; p < 0.01), and PFS (HR = 0.65, 95%CI: 0.51-0.81; p < 0.01). Administration of bevacizumab in mCRC patients with resected primary tumor had a better OS (HR = 0.65, 95%CI: 0.56-0.74; p < 0.01), when compared to chemotherapy(CT). Adding bevacizumab to mCRC patients without resection of primary tumor also had a better OS (HR = 0.78, 95%CI: 0.65-0.94; p < 0.01) and PFS (HR = 0.71, 95%CI: 0.57-0.88; p < 0.01) compared to chemotherapy alone. In conclusion, mCRC patients with resected primary tumor have better survival than those without surgery of primary tumor when treated with bevacizumab. Primary tumor resection status should be taken into consideration when using bevacizumab in mCRC.