Second-line treatment strategies for RAS wild-type colorectal cancer: A systematic review and Network Meta-analysis (NMA).

Autor: Di Nardo P; Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy., Basile D; Unit of Medical Oncology, Lamezia Terme Hospital, Italy. Electronic address: deborabasile1090@gmail.com., Siciliano A; Unit of Medical Oncology, AO Pugliese-Ciaccio of Catanzaro, Italy., Pelizzari G; Department of Oncology, University Hospital of Udine, Italy., Corvaja C; Department of Medicine, University of Udine, Udine, Italy., Buriolla S; Department of Medicine, University of Udine, Udine, Italy., Ongaro E; Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy., Maria Grazia D; Unit of Medical Oncology, Lamezia Terme Hospital, Italy., Garattini SK; Department of Oncology, University Hospital of Udine, Italy., Foltran L; Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy., Guardascione M; Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy., Casagrande M; Department of Oncology, University Hospital of Udine, Italy., Buonadonna A; Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy., Prantera T; Unit of Medical Oncology, Lamezia Terme Hospital, Italy., Aprile G; Medical Oncology, ULSS 8 Berica, Vicenza, Italy., Puglisi F; Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy; Department of Medicine, University of Udine, Udine, Italy.
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2024 May; Vol. 56 (5), pp. 786-794. Date of Electronic Publication: 2023 Aug 14.
DOI: 10.1016/j.dld.2023.07.013
Abstrakt: Background: The optimal strategy for second-line (IIL) treatment in KRAS wt metastatic colorectal cancer (mCRC) is not determined yet.
Methods: A random-effect NMA of phase II/III RCTs was conducted to evaluate IIL treatment for all-RAS wt mCRC, comparing anti-EGFR or anti-VEGF, and chemotherapy (CT).
Results: Overall, 11 RCTs (3613 patients) were included. In KRAS wt patients, PFS was improved with anti-VEGF (HR 0.43) and anti-EGFR (HR 0.63) vs CT. However, anti-VEGF based therapy had the highest likelihood of being ranked as the best treatment in terms of PFS (SUCRA 99.3%) and OS (SUCRA 99.4%). Bevacizumab-based treatment is most likely to be the best treatment in terms of PFS (SUCRA 89.1%) and OS (SUCRA 86.7%).
Conclusions: Second line treatment with anti-VEGF and anti-EGFR improved PFS in mCRC patients, however, anti-VEGF based therapy, particularly CT plus bevacizumab, is the best treatment according to SUCRA in terms of PFS and OS.
Competing Interests: Conflict of interest F.P. reports receipt of grants/research supports from Astrazeneca, Eisai, and Roche, and receipt of honoraria or consultation fees from Amgen, Astrazeneca, Daichii Sankyo, Celgene, Eisai, Eli Lilly, Exact Sciences, Gilead, GSK, Ipsen, MSD, Novartis, Pierre-Fabre, Pfizer, Roche, Seagen, Takeda, and Viatris.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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