Bevacizumab with preoperative chemotherapy versus preoperative chemotherapy alone for colorectal cancer liver metastases

Lü, Zhen; Peng, Jian; Wang, Fu Long; Yuan, Yunfei; Wu, Jiang; Li, Yu Hong; Wu, Xiao; Chen, Gong; Ding, Pei Rong; Li, Li Ren; Kong, Ling Heng; Lin, Jun; Zhang, Rong Xin; Wan, De Sen; Pan, Zhi Zhong

doi:10.1097/md.0000000000004767

Cited by 7 publications

(7 citation statements)

References 24 publications

(32 reference statements)

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“…The meta-analyses that assessed the disease control rate [74, 77, 80, 83, 90] did not show any statistically significant differences between BEVA and no BEVA interventions. The comparison revealed low heterogeneity ( I 2 = 10%; p = 0.18)…”

Section: Resultsmentioning

confidence: 99%

“…We included 19 studies with 9856 participants for BEVA versus no BEVA [13, 42, 71–74, 76–78, 80–87, 90]. There was a significant difference in the subgroup with a quality of seven or more stars for patients treated with BEVA (MD = 4.52; 95% CI 3.26–7.10; p < 0.00001) and a high statistical heterogeneity ( I 2 = 90%; p = 0.0001) (see the electronic supplementary material, Fig.…”

Section: Resultsmentioning

confidence: 99%

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Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Silva

Araújo

Lima³

et al. 2018

BioDrugs

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BackgroundThe last decade has seen the increasing use of biological medicines in combination with chemotherapy containing 5-fluorouracil/oxaliplatin or irinotecan for the treatment of metastatic colorectal cancer (mCRC). These combinations have resulted in increased progression-free survival (PFS) in patients with mCRC; however, there are remaining concerns over the extent of their effect on overall survival (OS). Published studies to date suggest no major differences between the three currently available monoclonal antibodies (MoAbs); however, there are differences in costs. In addition, there is rising litigation in Brazil in order to access these medicines as they are currently not reimbursed.ObjectiveThe aim was to investigate the comparative effectiveness and safety of three MoAbs (bevacizumab, cetuximab and panitumumab) associated with fluoropyrimidine-based chemotherapy regimens and compared to fluoropyrimidine-based chemotherapy alone in patients with mCRC, through an updated systematic review and meta-analysis of concurrent or non-concurrent observational cohort studies, to guide authorities and the judiciary.MethodA systematic review and meta-analysis was performed based on cohort studies published in databases up to November 2017. Effectiveness measures included OS, PFS, post-progression survival (PPS), Response Evaluation Criteria In Solid Tumors (RECIST), response rate, metastasectomy and safety. The methodological quality of the studies was also evaluated.ResultsA total of 21 observational cohort studies were included. There were statistically significant and clinically relevant benefits in patients treated with bevacizumab versus no bevacizumab mainly around OS, PFS, PPS and the metastasectomy rate, but not for the disease control rates. However, there was an increase in treatment-related toxicities and concerns with the heterogeneity of the studies.ConclusionThe results pointed to an advantage in favor of bevacizumab for OS, PFS, PPS, and metastasectomy. Although this advantage may be considered clinically modest, bevacizumab represents a hope for increased survival and a chance of metastasectomy for patients with mCRC. However, there are serious adverse events associated with its use, especially severe hypertension and gastrointestinal perforation, that need to be considered.Electronic supplementary materialThe online version of this article (10.1007/s40259-018-0322-1) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Silva

Araújo

Lima³

et al. 2018

BioDrugs

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“…SCLM still has a clinical challenge, mainly because of the limited availability of tools that use promising prognostic markers to guide treatment. 21,22 Thus, there is an urgent requirement to find reliable predictors for prediction of survival and tumor recurrence in SCLM patients underwent hepatectomy. At present, mounting evidence indicates the role of serum-circulating lncRNAs as novel serum biomarkers for diagnosis and prognosis prediction of cancer.…”

Section: Discussionmentioning

confidence: 99%

<p>LncRNA CRNDE and lncRNA SNHG7 are Promising Biomarkers for Prognosis in Synchronous Colorectal Liver Metastasis Following Hepatectomy</p>

Zhang

Shi

Song

et al. 2020

CMAR

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Synchronous colorectal liver metastasis (SCLM) had limited availability of tools to predict survival and tumor recurrence. LncRNA CRNDE and lncRNA SNHG7 have been proven to be closely related to cancer progression. However, the predictive value of lncRNA CRNDE and lncRNA SNHG7 in cancer prognosis is still unclear. The purpose of this study was to investigate whether lncRNA CRNDE and lncRNA SNHG7 could be used as promising biomarkers for prognosis prediction of SCLM patients who underwent hepatectomy. Methods: The expression profile of lncRNA CRNDE and lncRNA SNHG7 in serum of SCLM patients was examined by qRT-PCR. The relationship between lncRNA expression and clinicopathological characteristics was analyzed. The Cox proportional-hazards regression model and Kaplan-Meier analysis were performed to analyze the association between lncRNA expression and overall survival (OS) and tumor recurrence of SCLM patients. Results: Levels of lncRNA CRNDE and lncRNA SNHG7 in patients who underwent recurrence or death were significantly higher than that of patients with recurrence-free or survival (P<0.01). Both lncRNA CRNDE high level and lncRNA SNHG7 high level showed a significant correlation with differentiation of primary tumor, invasion depth of primary focus, lymph node metastases, number of liver metastases, and liver metastasis grade. High levels of lncRNA CRNDE or lncRNA SNHG7 predicted shorter recurrence time, shorter OS time, higher recurrence rate and lower OS rate. Furthermore, lncRNA CRNDE and lncRNA SNHG7 were independent risk factors for high recurrence and poor OS in SCLM underwent hepatectomy. Conclusion: Taken together, lncRNA CRNDE and lncRNA SNHG7 could be promising biomarkers for prediction of OS and tumor recurrence in SCLM underwent hepatectomy.

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“…To evaluate the efficacy of TBS for prediction of conversion outcome and prognosis, the validation cohort included patients who received first-line treatment from May 2009 to June 2013 at our center in our previous study. 7 The patients in the validation cohort also met the inclusion criteria as the training cohort and there is no overlap of patients between the two cohorts. Informed consent for the use of the clinical data was obtained from the patients before first-line treatment.…”

Section: Study Populationmentioning

confidence: 99%

“…4,5 After systemic chemotherapy, 22.5-51.9% of these patients were qualified for liver local curative therapy to achieve the status of no evidence of disease (NED). 6,7 As a result, 5-year survival rate could be raised from 9% to 32% compared with systemic therapy alone. 5,8 Therefore, conversion treatment followed by liver local curative therapy is of great benefit for patients with initially unresectable CRLM and thus should be carefully considered.…”

Section: Introductionmentioning

confidence: 99%

Application of Tumor Burden Score for predicting conversion outcome in patients with initially unresectable colorectal liver metastases after first-line systemic therapy

Peng

Liu

et al. 2021

Therap Adv Gastroenterol

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Background: Patients with initially unresectable colorectal liver metastases (CRLM) could achieve survival benefit from successful conversion therapy. Recently, Tumor Burden Score (TBS) was proposed as a valuable index to predict outcome following resection of CRLM. The study is aimed to investigate the association of TBS with conversion outcome. Methods: A total of 234 patients who underwent first-line treatment in our center were enrolled as training cohort. The validation cohort was developed from 89 patients in our previous study. Cut-off value of TBS was calculated to stratify patients into two groups. Significance test and logistic regression model were used to examine the prediction value of TBS for conversion outcome after first-line systemic therapy. Kaplan–Meier method and Cox proportional hazard model were applied to assess the prognostic value of TBS. Results: TBS showed good discriminatory power [area under curve (AUC) 0.726, p < 0.001] with cut-off value defined as 14.3 in training cohort, which was validated in the validation cohort. Increasing TBS was related to adverse chemotherapy response and conversion outcome. Low TBS group had three times higher conversion rate than that in high TBS group (57.3% versus 19.0%, p < 0.001). Multivariate analysis indicated that high TBS [odds ratio (OR) = 3.676, 95% confidence interval (CI) 1.671–8.429, p = 0.002], first-line treatment response as stable disease (SD) or progressive disease (PD) (OR = 9.247; 95% CI 4.736–18.846, p < 0.001), and absence of targeted therapy (OR = 2.453, 95% CI 1.139–5.455, p = 0.024) were three independent risk factors for failure conversion outcome. High TBS was significantly associated with conversion outcome whatever chemotherapy response, addition of targeted therapy, and Kirsten rat sarcoma viral oncogene homolog (KRAS) status. High TBS was also associated with worse overall survival. Conclusion: TBS should be applied in clinical practice to predict conversion outcome in patients with initially unresectable CRLM.

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Bevacizumab with preoperative chemotherapy versus preoperative chemotherapy alone for colorectal cancer liver metastases

Cited by 7 publications

References 24 publications

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

<p>LncRNA CRNDE and lncRNA SNHG7 are Promising Biomarkers for Prognosis in Synchronous Colorectal Liver Metastasis Following Hepatectomy</p>

Application of Tumor Burden Score for predicting conversion outcome in patients with initially unresectable colorectal liver metastases after first-line systemic therapy

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