Bevacizumab Combined with Chemotherapy as First-line Therapy for Metastatic Colorectal Cancer: A Meta-analysis

QU Yanli; WANG Haifeng; TANG Yong

doi:10.3971/j.issn.1000-8578.2014.09.011

Cancer Research on Prevention and Treatment > 2014 > 41(09): 1002-1008. > DOI: 10.3971/j.issn.1000-8578.2014.09.011

QU Yanli, WANG Haifeng, TANG Yong. Bevacizumab Combined with Chemotherapy as First-line Therapy for Metastatic Colorectal Cancer: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 1002-1008. DOI: 10.3971/j.issn.1000-8578.2014.09.011

Citation:

PDF (2090 KB)

Bevacizumab Combined with Chemotherapy as First-line Therapy for Metastatic Colorectal Cancer: A Meta-analysis

1.Department of Digestive Tumor, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011,China; 2.Department of Radiotherapy of The Chest and Abdomen

More Information

Graphical Abstract

Abstract

Abstract

Objective To assess the efficacy and safety of bevacizumab(BEV) combined with chemotherapy as a first-line therapy for metastatic colorectal cancer(mCRC). Methods A wide search of randomized clinical trials using BEV combined with chemotherapy as a first-line therapy for mCRC patients was performed in the Cochrane Library，PubMed，EmBase and CBM，CNKI，VIP，WanFang databases. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes were objective response rate (ORR) and toxicity. Relative risk (RR) and hazard ratios (HR) were expressed by 95% confidence intervals (95%CI). The software Stata 11.0 was used for meta-analysis. Results We involved 9 RCT trials, totally 3930 patients. Meta analysis indicated that compared with chemotherapy alone, BEV combined with chemotherapy could decrease the risk of progressive disease（HR=0.62, P<0.0001, 95%CI: 0.64-0.74）and the risk of disease death（HR=0.84, P<0.001, 95%CI: 0.73-0.95）, and could increase the ORR of mCRC patients（RR=0.80, P<0.001, 95%CI: 0.60-0.93）. Subgroup analysis indicated that the combination of BEV and double therapy could decrease the risk of progressive disease（HR=0.68, P<0.001, 95%CI: 0.46-0.89），but no decrease in the risk of disease death(HR=0.85, P=0.068, 95%CI: 0.68-1.03). The combination of BEV and monotherapy could decrease the risk of progressive disease(HR=0.56, P<0.001, 95%CI: 0.47-0.64) and the risk of disease death(HR=0.83, P<0.001, 95%CI: 0.68-0.97). Regarding the toxicity, BEV combined with chemotherapy didn't increase the treatment-related mortality(RR=0.97, P=0.91, 95%CI: 0.62-1.54), but increased the rates of BEV-associated adverse effects. Conclusion BEV combined with chemotherapy as a first-line treatment could increase the PFS,OS and ORR of mCRC patients. The benefit was dissimilar between BEV with monotherapy and BEV with double therapy. Although the BEVassociated adverse effect was increased, they could be controlled.
- Bevacizumab,
- Chemotherapy,
- Colorectal cancer,
- Meta-analysis

FullText(HTML)

References (16)

References

[1]	Hurwitz H, Fehrenbacher L, Novotny W,et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer[J].N Engl J Med,2004,350(23):2335-42.
[2]	Alessandro Passardi, Emanuela Scarpi, Luigi Cavanna, et al. Effectiveness of bevacizumab added to gold standard chemotherapy in metastatic colorectal cancer (mCRC): Final results from the Itaca randomized clinical trial[J]. J Clin Oncol, 20 13 ASCO Annual Meeting Abstracts,3517.
[3]	Saltz LB, Clarke S, Díaz-Rubio E, et al. Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase Ⅲ study [J]. J Clin Oncol,2008,26(12):2013-9.
[4]	Stathopoulos GP, Batziou C, Trafalis D, et al. Treatment of colorectal cancer with and without bevacizumab: a phase Ⅲ study[J].Oncology,2010,78(5-6):376-81.
[5]	Guan ZZ, Xu JM, Luo RC, et al. Efficacy and safety of bevacizumab plus chemotherapy in Chinese patients with metastatic colorectal cancer: a randomized phase Ⅲ ARTIST trial[J]. Chin J Cancer, 2011,30(10):682-9.
[6]	Kabbinavar F, Hurwitz HI, Fehrenbacher L, et al. Phase Ⅱ, randomized trial comparing bevacizumab plus fluorouracil (FU)/ leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer[J]. J Clin Oncol, 2003,21(1):60-5.
[7]	Kabbinavar FF, Schulz J, McCleod M, et al. Addition of bevacizumab to bolus fluorouracil and leucovorin in first-line metastatic colorectal cancer: results of a randomized phase Ⅱ trial [J] J Clin Oncol, 2005,23(16):3697-705.
[8]	Tebbutt NC, Wilson K, Gebski VJ, et al. Capecitabine, bevacizumab, and mitomycin in first-line treatment of metastatic colorectal cancer: results of the Australasian Gastrointestinal Trials Group Randomized Phase Ⅲ MAX Study[J].J Clin Oncol, 20 10,28(19):3191-8.
[9]	Cunningham D, Lang I, Marcuello E, et al. Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial[J].Lancet Oncol,2013,14 (11) :1077-85.
[10]	Kozloff M, Yood MU, Berlin J, et al.Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: The BRiTE observational cohort study[J]. Oncologist, 20 09,14(9):862-70.
[11]	Van Cutsem E, Rivera F, Berry S, et al. Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study[J].Ann Oncol,2009,20(11):1842-7.
[12]	Hurwitz HI, Tebbutt NC, Kabbinavar F, et al. Efficacy and safety of bevacizumab in metastatic colorectal cancer: pooled analysis from seven randomized controlled trials[J].Oncologist, 20 13,18(9):1004-12.
[13]	Macedo LT, da Costa Lima AB, Sasse AD. Addition of bevacizumab to first-line chemotherapy in advanced colorectal cancer: a systematic review and meta-analysis, with emphasis on chemotherapy subgroups[J].BMC Cancer, 2012,12:89.
[14]	Loupakis F, Bria E, Vaccaro V, et al. Magnitude of benefit of the addition of bevacizumab to first-line chemotherapy for metastatic colorectal cancer: meta-analysis of randomized clinical trials[J].J Exp Clin Cancer Res,2010, 29:58.
[15]	Strickler JH, Hurwitz HI. Bevacizumab-based therapies in the first-line treatment of metastatic colorectal cancer[J].Oncologist, 20 12,17(4):513-24.
[16]	Dai F, Shu L, Bian Y, et al. Safety of bevacizumab in treating metastatic colorectal cancer: a systematic review and meta-analysis of all randomized clinical trials[J].Clin Drug Investig,2013,33(11): 77 9-88.

[1]	XIA Lin, YU Guozheng, TANG Jing. Diagnostic Value of Circular RNAs for Colorectal Cancer: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2021, 48(9): 864-870. DOI: 10.3971/j.issn.1000-8578.2021.21.0069
[2]	LIANG Tong, LIU Huajie, DA Mingxu. Metabolic Syndrome and Risk of Gastric Cancer: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2021, 48(3): 268-273. DOI: 10.3971/j.issn.1000-8578.2021.20.0957
[3]	JIAN Yaowen, WANG Lei, Liu Ye, HE Mingyan, RANG Weiqing. A Meta-analysis of Dietary Vitamin Consumption and Risk of Hepatocellular Carcinoma[J]. Cancer Research on Prevention and Treatment, 2020, 47(2): 108-111. DOI: 10.3971/j.issn.1000-8578.2020.19.0007
[4]	ZHAO Rongchang, YU Wenyan, FENG Yuxin, ZHANG Wanli, ZHU Chunrong. Comparison of Efficacy Between S-1 and Capecitabine/Fluorouracil on Advanced Colorectal Cancer: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2019, 46(12): 1123-1130. DOI: 10.3971/j.issn.1000-8578.2019.19.0138
[5]	RAO Xionghui, LUO Hongliang, HUANG Jun, ZHU Zhengming. Prognostic and Clinicopathological Significance of PD-L1 Expression for Colorectal Cancer: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2019, 46(11): 1013-1021. DOI: 10.3971/j.issn.1000-8578.2019.19.0363
[6]	JIAN Yaowen, XIONG Wenjing, LIU Ye, LIU Yang, YANG Huixian, RANG Weiqing. A Meta-analysis on Relationship of Dietary Factors with Liver Cancer in Chinese Population[J]. Cancer Research on Prevention and Treatment, 2017, 44(7): 493-500. DOI: 10.3971/j.issn.1000-8578.2017.16.1465
[7]	YU Huihui, WEI Lixuan, LIU Yunyong, XING Xiaojing. Meta-analysis of Relationship Between Blood 25-hydroxyvitamin D Level and Colorectal Cancer[J]. Cancer Research on Prevention and Treatment, 2015, 42(04): 394-398. DOI: 10.3971/j.issn.1000-8578.2015.04.017
[8]	LIU Min, SONG Yang, YANG Fuguo. Effect of Food Intake on Risk of Rectal Cancer: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2014, 41(12): 1343-1347. DOI: 10.3971/j.issn.1000-8578.2014.12.020
[9]	Yao Zhiwen, Zhao Zhenlong, Jiang Yumei, Mi Ying, Gu Miaoning. Meta-analysis for Association between Polymorphism of COX-2 -1195G>A and Colorectal Cancer Susceptibility[J]. Cancer Research on Prevention and Treatment, 2012, 39(02): 213-217. DOI: 10.3971/j.issn.1000-8578.2012.02.024
[10]	QIU Yue-feng, CAI Lin. Meta-analysis on Relationship between Body Mass Index and Lung Cancer Risk[J]. Cancer Research on Prevention and Treatment, 2010, 37(02): 218-222. DOI: 10.3971/j.issn.1000-8578.2010.02.025

Cited By

Get Citation

PDF

XML

Article views (1322) PDF downloads (388)

Turn off MathJax

Article Contents

Abstract

References

Bevacizumab Combined with Chemotherapy as First-line Therapy for Metastatic Colorectal Cancer: A Meta-analysis

Abstract

References

Related Articles

Catalog

Download Center

Links

Contact Us

Bevacizumab Combined with Chemotherapy as First-line Therapy for Metastatic Colorectal Cancer: A Meta-analysis

Abstract

References

Related Articles

Catalog

Download Center

Links

Contact Us

Export File

Citation

Format

Content