The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis
Abstract Patients with locally advanced rectal cancer (LARC) are at tremendous risk of metastatic diseases. To improve the prognoses of LARC patients, the efficacy of adding targeted agents to neoadjuvant therapy has been investigated by many researchers but remains controversial. A literature searc...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1298 |
| _version_ | 1797390112543211520 |
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| author | Xi Zhong Zhonghua Wu Peng Gao Jinxin Shi Jingxu Sun Zhexu Guo Zhenning Wang Yongxi Song |
| author_facet | Xi Zhong Zhonghua Wu Peng Gao Jinxin Shi Jingxu Sun Zhexu Guo Zhenning Wang Yongxi Song |
| author_sort | Xi Zhong |
| collection | DOAJ |
| description | Abstract Patients with locally advanced rectal cancer (LARC) are at tremendous risk of metastatic diseases. To improve the prognoses of LARC patients, the efficacy of adding targeted agents to neoadjuvant therapy has been investigated by many researchers but remains controversial. A literature search of relevant databases was conducted through December 2016, 804 studies were identified and 32 investigations were ultimately included. A total of 1196 patients from 31 cohorts of 29 studies were eligible for quantitative synthesis in this single‐arm setting meta‐analysis. As pathologic complete response (pCR) shows promise as a prognosis indicator, we focused on pCR rates to evaluate whether adding targeted agents to neoadjuvant therapies improves the outcome of LARC patients. In our study, we revealed pooled estimates of pCR of 27% (95%CI, 21–34%) and 14% (95%CI, 9–21%) for bevacizumab‐relevant cohorts and cetuximab‐relevant cohorts, respectively. The safety of adding targeted agents to neoadjuvant therapy was also evaluated by pooling the data of Grade 3/4 toxicity. In conclusion, our study revealed that adding bevacizumab to the neoadjuvant therapy regimens provides appreciable pCR for LARC patients. Meanwhile, the efficacy of cetuximab remains inconclusive, RCTs with larger scale and better study design that stress more on mutational status are needed. |
| first_indexed | 2024-03-08T23:06:56Z |
| format | Article |
| id | doaj.art-e71374ce88214e8f8c3bd20d494ae3e0 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T23:06:56Z |
| publishDate | 2018-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-e71374ce88214e8f8c3bd20d494ae3e02023-12-15T12:32:12ZengWileyCancer Medicine2045-76342018-03-017356558210.1002/cam4.1298The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysisXi Zhong0Zhonghua Wu1Peng Gao2Jinxin Shi3Jingxu Sun4Zhexu Guo5Zhenning Wang6Yongxi Song7Department of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaDepartment of Surgical Oncology and General Surgery The First Hospital of China Medical University 155 North Nanjing Street Heping District Shenyang 110001 ChinaAbstract Patients with locally advanced rectal cancer (LARC) are at tremendous risk of metastatic diseases. To improve the prognoses of LARC patients, the efficacy of adding targeted agents to neoadjuvant therapy has been investigated by many researchers but remains controversial. A literature search of relevant databases was conducted through December 2016, 804 studies were identified and 32 investigations were ultimately included. A total of 1196 patients from 31 cohorts of 29 studies were eligible for quantitative synthesis in this single‐arm setting meta‐analysis. As pathologic complete response (pCR) shows promise as a prognosis indicator, we focused on pCR rates to evaluate whether adding targeted agents to neoadjuvant therapies improves the outcome of LARC patients. In our study, we revealed pooled estimates of pCR of 27% (95%CI, 21–34%) and 14% (95%CI, 9–21%) for bevacizumab‐relevant cohorts and cetuximab‐relevant cohorts, respectively. The safety of adding targeted agents to neoadjuvant therapy was also evaluated by pooling the data of Grade 3/4 toxicity. In conclusion, our study revealed that adding bevacizumab to the neoadjuvant therapy regimens provides appreciable pCR for LARC patients. Meanwhile, the efficacy of cetuximab remains inconclusive, RCTs with larger scale and better study design that stress more on mutational status are needed.https://doi.org/10.1002/cam4.1298Efficacyneoadjuvant therapypathologic complete responserectal cancertargeted agents |
| spellingShingle | Xi Zhong Zhonghua Wu Peng Gao Jinxin Shi Jingxu Sun Zhexu Guo Zhenning Wang Yongxi Song The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis Cancer Medicine Efficacy neoadjuvant therapy pathologic complete response rectal cancer targeted agents |
| title | The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis |
| title_full | The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis |
| title_fullStr | The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis |
| title_full_unstemmed | The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis |
| title_short | The efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis |
| title_sort | efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients a meta analysis |
| topic | Efficacy neoadjuvant therapy pathologic complete response rectal cancer targeted agents |
| url | https://doi.org/10.1002/cam4.1298 |
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