First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis
Abstract Background A first-line biologic treatment for metastatic colorectal cancer (mCRC) is still controversial. We, therefore, performed a meta-analysis to determine the efficacy of first-line cetuximab versus bevacizumab for RAS and BRAF wild-type mCRC. Methods In March 2018, an electronic sear...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5481-z |
| _version_ | 1819086765586120704 |
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| author | Bobo Zheng Xin Wang Mingtian Wei Quan Wang Jiang Li Liang Bi Xiangbing Deng Ziqiang Wang |
| author_facet | Bobo Zheng Xin Wang Mingtian Wei Quan Wang Jiang Li Liang Bi Xiangbing Deng Ziqiang Wang |
| author_sort | Bobo Zheng |
| collection | DOAJ |
| description | Abstract Background A first-line biologic treatment for metastatic colorectal cancer (mCRC) is still controversial. We, therefore, performed a meta-analysis to determine the efficacy of first-line cetuximab versus bevacizumab for RAS and BRAF wild-type mCRC. Methods In March 2018, an electronic search of the following biomedical databases was performed: PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov and Web of Knowledge. Randomized controlled trials (RCTs) and prospective or observational cohort studies (OCSs) were included. Subgroup analyses of all RCTs were performed in all outcomes. All statistical analyses were performed using RevMan software 5.3. Results Two RCTs and three OCSs, involving a total 2576 patients, were included. The meta-analysis reported that cetuximab was associated with a longer overall survival (OS) [HR 0.89, 95% CI (0.81–0.98); p = 0.02], a higher ORR [RR 1.11, 95% CI (1.03–1.19); p = 0.006], higher complete response [RR 3.21, 95% CI (1.27–8.12); p = 0.01] and a greater median depth of response than bevacizumab. However, no significant difference was observed between cetuximab and bevacizumab groups for PFS, DCR, partial response, progressive disease, curative intent metastasectomy, EORR and incidence of grade 3 or higher adverse events. In the subgroup meta-analyses of the RCTs, inconsistent results compared to the main analysis, however, were found, in the ORR, DCR and curative intent metastasectomy. Conclusions The current evidence indicates that compared to bevacizumab treatment, cetuximab provides a clinically relevant effect in first-line treatment against mCRC, at the cost of having lower stable disease. |
| first_indexed | 2024-12-21T21:25:27Z |
| format | Article |
| id | doaj.art-1c1b6334a82d42e290b73759e43ab6fe |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-21T21:25:27Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-1c1b6334a82d42e290b73759e43ab6fe2022-12-21T18:49:46ZengBMCBMC Cancer1471-24072019-03-0119111210.1186/s12885-019-5481-zFirst-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysisBobo Zheng0Xin Wang1Mingtian Wei2Quan Wang3Jiang Li4Liang Bi5Xiangbing Deng6Ziqiang Wang7Department of Gastrointestinal Surgery, West China Hospital, Sichuan UniversityDepartment of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan UniversityDigestive disease hospital, Xijing Hospital, The Fourth Military Medical UniversityNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan UniversityDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan UniversityDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan UniversityAbstract Background A first-line biologic treatment for metastatic colorectal cancer (mCRC) is still controversial. We, therefore, performed a meta-analysis to determine the efficacy of first-line cetuximab versus bevacizumab for RAS and BRAF wild-type mCRC. Methods In March 2018, an electronic search of the following biomedical databases was performed: PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov and Web of Knowledge. Randomized controlled trials (RCTs) and prospective or observational cohort studies (OCSs) were included. Subgroup analyses of all RCTs were performed in all outcomes. All statistical analyses were performed using RevMan software 5.3. Results Two RCTs and three OCSs, involving a total 2576 patients, were included. The meta-analysis reported that cetuximab was associated with a longer overall survival (OS) [HR 0.89, 95% CI (0.81–0.98); p = 0.02], a higher ORR [RR 1.11, 95% CI (1.03–1.19); p = 0.006], higher complete response [RR 3.21, 95% CI (1.27–8.12); p = 0.01] and a greater median depth of response than bevacizumab. However, no significant difference was observed between cetuximab and bevacizumab groups for PFS, DCR, partial response, progressive disease, curative intent metastasectomy, EORR and incidence of grade 3 or higher adverse events. In the subgroup meta-analyses of the RCTs, inconsistent results compared to the main analysis, however, were found, in the ORR, DCR and curative intent metastasectomy. Conclusions The current evidence indicates that compared to bevacizumab treatment, cetuximab provides a clinically relevant effect in first-line treatment against mCRC, at the cost of having lower stable disease.http://link.springer.com/article/10.1186/s12885-019-5481-zFirst lineCetuximabBevacizumabWild typeMetastatic colorectal cancer |
| spellingShingle | Bobo Zheng Xin Wang Mingtian Wei Quan Wang Jiang Li Liang Bi Xiangbing Deng Ziqiang Wang First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis BMC Cancer First line Cetuximab Bevacizumab Wild type Metastatic colorectal cancer |
| title | First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis |
| title_full | First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis |
| title_fullStr | First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis |
| title_full_unstemmed | First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis |
| title_short | First-line cetuximab versus bevacizumab for RAS and BRAF wild-type metastatic colorectal cancer: a systematic review and meta-analysis |
| title_sort | first line cetuximab versus bevacizumab for ras and braf wild type metastatic colorectal cancer a systematic review and meta analysis |
| topic | First line Cetuximab Bevacizumab Wild type Metastatic colorectal cancer |
| url | http://link.springer.com/article/10.1186/s12885-019-5481-z |
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