Treatment with Antiangiogenic Drugs in Multiple Lines in Patients with Metastatic Colorectal Cancer: Meta-Analysis of Randomized Trials
| Autor: | I. Burkholder, U. Ronellenfitsch, Stefan Kubicka, Alfredo Falcone, R.D. Hofheinz, U. T. Hacker |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Future studies Colorectal cancer Disease Review Article Pharmacology law.invention 03 medical and health sciences 0302 clinical medicine Stable Disease Randomized controlled trial law Internal medicine medicine In patient lcsh:RC799-869 Hepatology business.industry Gastroenterology medicine.disease 030104 developmental biology 030220 oncology & carcinogenesis Meta-analysis lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Gastroenterology Research and Practice, Vol 2016 (2016) Gastroenterology Research and Practice |
| Popis: | Background. In metastatic colorectal cancer (mCRC), continuing antiangiogenic drugs beyond progression might provide clinical benefit. We synthesized the available evidence in a meta-analysis.Patients and Methods. We conducted a meta-analysis of studies investigating the use of antiangiogenic drugs beyond progression. Eligible studies were randomized phase II/III trials. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Secondary endpoints were the impact of continuing antiangiogenic drugs (i) in subgroups, (ii) in different types of compounds targeting the VEGF-axis (monoclonal antibodies versus tyrosine kinase inhibitors), and (iii) on remission rates and prevention of progression.Results. Eight studies (3,668 patients) were included. Continuing antiangiogenic treatment beyond progression significantly improved PFS (HR 0.64; 95%-CI, 0.55–0.75) and OS (HR 0.83; 95%-CI, 0.76–0.89). PFS was significantly improved in all subgroups with comparable HR. OS was improved in all subgroups stratified by age, gender, and ECOG status. The rate of patients achieving at least stable disease was improved with an OR of 2.25 (95%-CI, 1.41–3.58).Conclusions. This analysis shows a significant PFS and OS benefit as well as a benefit regarding disease stabilization when using antiangiogenic drugs beyond progression in mCRC. Future studies should focus on the optimal sequence of administering antiangiogenic drugs. |
| Databáze: | OpenAIRE |
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