Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis
Abstract Background To date, the optimal treatment for potentially resectable metastatic colorectal cancer (mCRC) patients has yet to be determined. Encouraging results have been reported in studies exploring the efficacy of triplet chemotherapy plus anti-epidermal growth factor receptor (anti-EGFR)...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02707-x |
| _version_ | 1828434696941338624 |
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| author | Qian Wu Huan Wang Suqin Zhang Yifei Zeng Wei Yang Wenjun Pan Guodai Hong Wenbin Gao |
| author_facet | Qian Wu Huan Wang Suqin Zhang Yifei Zeng Wei Yang Wenjun Pan Guodai Hong Wenbin Gao |
| author_sort | Qian Wu |
| collection | DOAJ |
| description | Abstract Background To date, the optimal treatment for potentially resectable metastatic colorectal cancer (mCRC) patients has yet to be determined. Encouraging results have been reported in studies exploring the efficacy of triplet chemotherapy plus anti-epidermal growth factor receptor (anti-EGFR) target agents. Thus, we conducted a meta-analysis to evaluate the efficacy and safety of triplet chemotherapy plus anti-EGFR target agents. Methods We systematically searched the PubMed, Embase, and Web of Science databases from December 2004 to October 2021 for studies examining the efficacy of triplet chemotherapy plus anti-EGFR target agents in mCRC patients. The primary outcomes were the objective response rate (ORR) and R0 resection rate (R0RR), and the secondary outcomes were median progression-free survival (mPFS), median overall survival (mOS), and toxicity. Data were analyzed with R software 4.1.2. Results Fourteen studies comprising 762 patients with mCRC were included in this meta-analysis. Analysis with a random effects model revealed that after treatment with triplet chemotherapy plus anti-EGFR target agents, the pooled ORR was 82% (95% CI= 76–88%, I 2= 76%), and the pooled R0RR of colorectal liver metastasis (CLM) was 59% (95% CI= 49–68%, I 2= 60%). The mPFS ranged from 9.5 to 17.8 months, and the mOS ranged from 24.7 to 62.5 months. A total of 648 grade 3 or 4 adverse events were reported; the most commonly reported events were diarrhea (174/648), neutropenia (157/648), and skin toxicity (95/648), which had pooled prevalence rates of 29% (95% CI= 20–39%, I 2= 84%), 28% (95% CI= 20–37%, I 2= 77%), and 17% (95% CI= 11–24%, I 2= 66%), respectively. Conclusions Triplet chemotherapy plus anti-EGFR agents therapy seems to be capable of increasing the ORR of mCRC patients and the R0RR of CLM patients. The toxicity of this treatment is manageable. High-quality randomized controlled trial (RCT) studies are required for further validation. |
| first_indexed | 2024-12-10T18:53:59Z |
| format | Article |
| id | doaj.art-f312e6bb7f4849aa890efe815bb03ae4 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-10T18:53:59Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-f312e6bb7f4849aa890efe815bb03ae42022-12-22T01:37:14ZengBMCWorld Journal of Surgical Oncology1477-78192022-08-0120111610.1186/s12957-022-02707-xEfficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysisQian Wu0Huan Wang1Suqin Zhang2Yifei Zeng3Wei Yang4Wenjun Pan5Guodai Hong6Wenbin Gao7Department of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalDepartment of Oncology, Shenzhen Luohu People’s HospitalAbstract Background To date, the optimal treatment for potentially resectable metastatic colorectal cancer (mCRC) patients has yet to be determined. Encouraging results have been reported in studies exploring the efficacy of triplet chemotherapy plus anti-epidermal growth factor receptor (anti-EGFR) target agents. Thus, we conducted a meta-analysis to evaluate the efficacy and safety of triplet chemotherapy plus anti-EGFR target agents. Methods We systematically searched the PubMed, Embase, and Web of Science databases from December 2004 to October 2021 for studies examining the efficacy of triplet chemotherapy plus anti-EGFR target agents in mCRC patients. The primary outcomes were the objective response rate (ORR) and R0 resection rate (R0RR), and the secondary outcomes were median progression-free survival (mPFS), median overall survival (mOS), and toxicity. Data were analyzed with R software 4.1.2. Results Fourteen studies comprising 762 patients with mCRC were included in this meta-analysis. Analysis with a random effects model revealed that after treatment with triplet chemotherapy plus anti-EGFR target agents, the pooled ORR was 82% (95% CI= 76–88%, I 2= 76%), and the pooled R0RR of colorectal liver metastasis (CLM) was 59% (95% CI= 49–68%, I 2= 60%). The mPFS ranged from 9.5 to 17.8 months, and the mOS ranged from 24.7 to 62.5 months. A total of 648 grade 3 or 4 adverse events were reported; the most commonly reported events were diarrhea (174/648), neutropenia (157/648), and skin toxicity (95/648), which had pooled prevalence rates of 29% (95% CI= 20–39%, I 2= 84%), 28% (95% CI= 20–37%, I 2= 77%), and 17% (95% CI= 11–24%, I 2= 66%), respectively. Conclusions Triplet chemotherapy plus anti-EGFR agents therapy seems to be capable of increasing the ORR of mCRC patients and the R0RR of CLM patients. The toxicity of this treatment is manageable. High-quality randomized controlled trial (RCT) studies are required for further validation.https://doi.org/10.1186/s12957-022-02707-xMetastatic colorectal cancerAnti-EGFRTriplet chemotherapyCetuximabPanitumumab |
| spellingShingle | Qian Wu Huan Wang Suqin Zhang Yifei Zeng Wei Yang Wenjun Pan Guodai Hong Wenbin Gao Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis World Journal of Surgical Oncology Metastatic colorectal cancer Anti-EGFR Triplet chemotherapy Cetuximab Panitumumab |
| title | Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis |
| title_full | Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis |
| title_short | Efficacy and safety of triplet chemotherapy plus anti-EGFR agents in metastatic colorectal cancer: a systematic review and meta-analysis |
| title_sort | efficacy and safety of triplet chemotherapy plus anti egfr agents in metastatic colorectal cancer a systematic review and meta analysis |
| topic | Metastatic colorectal cancer Anti-EGFR Triplet chemotherapy Cetuximab Panitumumab |
| url | https://doi.org/10.1186/s12957-022-02707-x |
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