Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer

Bai, Long; Wang, Rui; Li, Zhe Zhen; Ren, Chao; Zhang, Dong Sheng; Zhao, Qi; Lü, Yun; Wang, De Shen; Qiu, Miao Zhen; Wang, Zhi Qiang; Wang, Feng Hua; Xu, Rui‐Hua

doi:10.1097/md.0000000000004531

Cited by 14 publications

(18 citation statements)

References 56 publications

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“…We included 16 studies on OS, with 11,094 participants. There were significant differences between the groups BEVA versus no BEVA [13, 42, 71, 73, 74, 77, 78, 81–87] (MD = 4.07; 95% CI 1.69–6.45; p < 0.001; I 2 = 81%). However, when we look at the clusters of CT regimens separately, we note the following: there were no statistically significant differences between the subgroups of BEVA + CT versus CT alone [13, 71, 78, 82] (MD = 2.83; 95% CI − 1.76 to 7.41; p = 0.23; I 2 = 87%); BEVA + CT versus CETUX + CT [74, 77, 86, 87] (MD = − 0.52; 95% CI − 7.7 to 6.67; p = 0.89; I 2 = 0%) and BEVA + FOLFOX versus FOLFOX [13, 83] (MD = 8.63; 95% CI − 9.93 to 27.19; p = 0.36; I 2 = 96%).…”

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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“…ese drugs, however, have functional limitations and very o en numerous side effects. For example, cetuximab is most of all used in patients with a nonmutated (wild type) KRAS gene [7,8]. Moreover, in the CRC treatment area, solutions of chemotherapy combined with hyperthermia are introduced.…”

Section: Introductionmentioning

confidence: 99%

Increased Temperature Facilitates Adeno-Associated Virus Vector Transduction of Colorectal Cancer Cell Lines in a Manner Dependent on Heat Shock Protein Signature

Bieńkowska

Kuźmicka

Ciepiela

et al. 2020

BioMed Research International

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Colorectal cancer (CRC) is one of the most common cancers in human population. A great achievement in the treatment of CRC was the introduction of targeted biological drugs and solutions of chemotherapy, combined with hyperthermia. Cytoreductive surgery and HIPEC (hyperthermic intraperitoneal chemotherapy) extends the patients’ survival with CRC. Recently, gene therapy approaches are also postulated. The studies indicate the possibility of enhancing the gene transfer to cells by recombinant adeno-associated vectors (rAAV) at hyperthermia. The rAAV vectors arouse a lot of attention in the field of cancer treatment due to many advantages. In this study, the effect of elevated temperature on the transduction efficiency of rAAV vectors on CRC cells with different origin and gene profile was examined. The effect of heat shock on the penetration of rAAV vectors into CRC cells in relation with the expression of HSP and AAV receptor genes was tested. It was found that the examined cells under hyperthermia (43°C, 1 h) are transduced at a higher level than in normal conditions (37°C). The results also indicate that studied RKO, HT-29, and LS411N cell lines express HSP genes at different levels under both 37°C and 43°C. Moreover, the results showed that the expression of AAV receptors increases in response to elevated temperature. The study suggests that increased rAAV transfer to CRC can be achieved under elevated temperature conditions. The obtained results provide information relevant to the design of new solutions in CRC therapy based on the combination of hyperthermia, chemotherapy, and gene therapy.

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“…[ 3 , 4 ] The development of targeted anticancer agents, such as cetuximab and panitumumab, in the last few decades has effectively prolonged the survival rate of patients with CRC. [ 5 ] However, the survival rate and prognosis of patients with CRC are not ideal. Thus, it is essential to explore a novel biomarker for a more precise treatment of CRC.…”

Section: Introductionmentioning

confidence: 99%

Association between the overexpression of Her3 and clinical pathology and prognosis of colorectal cancer

et al. 2018

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Background:This study aimed to investigate the association between the overexpression of human epidermal growth factor receptor-3 (Her3) and the clinicopathological parameters and survival of patients with colorectal cancer (CRC).Methods:Relevant studies on the overexpression of Her3 (measured by immunohistochemistry) and overall survival (OS) in patients with CRC were searched for in PubMed, EMBASE, and Cochrane Library. Published data were extracted and computed into odds ratios (ORs) for assessing the association of Her3 overexpression with tumor differentiation, tumor node metastasis (TNM) stage, position of colon cancer, sex, and age. Prognostic data were computed into hazard ratios (HRs) for OS.Results:Eight studies including 1716 patients with CRC were included in this meta-analysis. The results revealed a significant association between Her3 overexpression and tumor differentiation [OR = 2.38; 95% confidence interval (95% CI): 1.76–3.22; P < .001], TNM tumor stage (OR = 0.71; 95% CI: 0.53–0.96; P = .03), and position of colon cancer (OR = 1.71; 95% CI: 1.28–2.27; P < .001). While patients with Her3 overexpression demonstrated a worse tumor response (OR = 0.31; 95% CI: 0.16–0.60; P < .001) and OS after treatment with cetuximab (HR = 1.86; 95% CI: 1.24–2.79; P = .003), they demonstrated better OS after symptomatic treatment (HR = 0.65; 95% CI: 0.50–0.85; P = .002). Her3 overexpression was not associated with sex (OR = 1.03; 95% CI: 0.83–1.28; P = .79), age (OR = 0.96; 95% CI: 0.75–1.24; P = .77), colon or rectum site (OR = 0.79; 95% CI: 0.44–1.43; P = .44), and total OS (HR = 1.09; 95% CI: 0.69–1.72; P = .72).Conclusion:Her3 expression is associated with the clinical pathology and prognosis of CRC, which explains the nonefficacy of cetuximab treatment in patients with CRC.

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Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer

Abstract: Supplemental Digital Content is available in the text

Cited by 14 publications

References 56 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

Increased Temperature Facilitates Adeno-Associated Virus Vector Transduction of Colorectal Cancer Cell Lines in a Manner Dependent on Heat Shock Protein Signature

Association between the overexpression of Her3 and clinical pathology and prognosis of colorectal cancer

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