Meta-analysis comparing maintenance strategies with continuous therapy and complete chemotherapy-free interval strategies in the treatment of metastatic colorectal cancer
There is as yet no consensus as to the best choice among the three treatment options (maintenance, complete chemotherapy-free intervals [CFIs], and continuous) for metastatic colorectal cancer (CRC). We performed a meta-analysis of six trials (N = 2, 454 patients) to compare the safety and efficacy of those three treatment strategies. Maintenance appeared to offer an advantage over CFI with respect to progression-free survival (PFS) (hazard ratio [HR]: 0.53, 95% confidence interval [CI], 0.40-0.69). PFS and overall survival (OS) were comparable between the maintenance and continuous strategies (HR: 1.18, 95% CI, 0.96-1.46; HR: 1.05, 95% CI, 0.98-1.27, respectively), as was OS between the maintenance and CFI strategies (HR: 0.84; 95% CI, 0.70-1.00). The incidence of grade 3/4 toxicity, including neutropenia, neuropathy, hand-foot syndrome and fatigue, was lower with maintenance than with continuous therapy. A maintenance regimen utilizing bevacizumab-based doublets appeared to confer a slight advantage over bevacizumab monotherapy with respect to PFS (P = 0.011). Maintenance appeared to reduce cumulative grade 3/4 toxicity as compared to the continuous strategy, while showing comparable efficacy. Bevacizumab-based doublets appeared to be of particular value in patients with metastatic CRC.
基金:
National Key Basic Research Program of ChinaNational Basic Research Program of China [2012CB526600]; Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases Foundation Project; Beijing Talents Fund [2014000021469G268]
第一作者单位:[1]Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
通讯作者:
推荐引用方式(GB/T 7714):
Zhao Lei,Wang Jing,Li Huihui,et al.Meta-analysis comparing maintenance strategies with continuous therapy and complete chemotherapy-free interval strategies in the treatment of metastatic colorectal cancer[J].ONCOTARGET.2016,7(22):33418-33428.doi:10.18632/oncotarget.8644.
APA:
Zhao, Lei,Wang, Jing,Li, Huihui,Che, Juanjuan&Cao, Bangwei.(2016).Meta-analysis comparing maintenance strategies with continuous therapy and complete chemotherapy-free interval strategies in the treatment of metastatic colorectal cancer.ONCOTARGET,7,(22)
MLA:
Zhao, Lei,et al."Meta-analysis comparing maintenance strategies with continuous therapy and complete chemotherapy-free interval strategies in the treatment of metastatic colorectal cancer".ONCOTARGET 7..22(2016):33418-33428