PDF(Pubmed)
Abstract：
Colorectal cancer is the most prevalent gastrointestinal neoplasm. When metastatic, the disease has limited systemic treatment options. Novel targeted therapies have expanded these options for subsets with specific molecular alterations, such as microsatellite instability (MSI)-high cancers, but additional treatments and combinations are in urgent need to improve outcomes and improve survival of this incurable disease. The fluoropyrimidine-derivative trifluridine, in combination with tipiracil, has been introduced as a third-line treatment, and more recently, it was studied in combination with bevacizumab. This meta-analysis reports on studies with this combination in clinical practice outside clinical trials.
A literature search in the Medline/PubMed and Embase databases was executed for finding series of trifluridine/tipiracil with bevacizumab in metastatic colorectal cancer. Criteria for inclusion in the meta-analysis were English or French language of the report, inclusion of twenty or more patients with metastatic colorectal cancer treated with trifluridine/tipiracil in combination with bevacizumab outside of a trial and containing information regarding response rates, progression-free survival (PFS), and overall survival (OS). Information on the demographics of the patients and on adverse effects of treatment was also collected.
Eight series with a total of 437 patients were eligible for the meta-analysis. The performed meta-analysis discovered a summary response rate (RR) of 2.71% (95% confidence interval (CI): 1.11-4.32%) and a disease control rate (DCR) of 59.63% (95% CI: 52.06-67.21%). Summary PFS was 4.56 months (95% CI: 3.57-5.55 months), and summary OS was 11.17 months (95% CI: 10.15-12.19 months). Common adverse effects identified mirrored the adverse-effect profile of the two components of the combination.
The current systematic review and meta-analysis reports the efficacy of trifluridine/tipiracil with bevacizumab in advanced lines of therapy for metastatic colorectal cancer in the setting of clinical practice outside clinical trials. Discovery of predictive biomarkers of response to trifluridine/tipiracil with bevacizumab will promote the tailoring of this treatment to individual patients to maximize clinical benefit.
A literature search in the Medline/PubMed and Embase databases was executed for finding series of trifluridine/tipiracil with bevacizumab in metastatic colorectal cancer. Criteria for inclusion in the meta-analysis were English or French language of the report, inclusion of twenty or more patients with metastatic colorectal cancer treated with trifluridine/tipiracil in combination with bevacizumab outside of a trial and containing information regarding response rates, progression-free survival (PFS), and overall survival (OS). Information on the demographics of the patients and on adverse effects of treatment was also collected.
Eight series with a total of 437 patients were eligible for the meta-analysis. The performed meta-analysis discovered a summary response rate (RR) of 2.71% (95% confidence interval (CI): 1.11-4.32%) and a disease control rate (DCR) of 59.63% (95% CI: 52.06-67.21%). Summary PFS was 4.56 months (95% CI: 3.57-5.55 months), and summary OS was 11.17 months (95% CI: 10.15-12.19 months). Common adverse effects identified mirrored the adverse-effect profile of the two components of the combination.
The current systematic review and meta-analysis reports the efficacy of trifluridine/tipiracil with bevacizumab in advanced lines of therapy for metastatic colorectal cancer in the setting of clinical practice outside clinical trials. Discovery of predictive biomarkers of response to trifluridine/tipiracil with bevacizumab will promote the tailoring of this treatment to individual patients to maximize clinical benefit.
摘要：
背景：结直肠癌是最常见的胃肠道肿瘤。当转移时，这种疾病的全身治疗选择有限.新的靶向疗法已经将这些选择扩展到具有特定分子改变的子集，如微卫星不稳定性（MSI）-高癌症，但迫切需要额外的治疗和联合治疗,以改善这种不治之症的预后和生存率.氟嘧啶衍生物三氟尿苷，与替吡拉嘧啶结合使用，已经作为第三线治疗引入，最近，这项研究是与贝伐单抗联合进行的.本荟萃分析报告了在临床试验之外的临床实践中使用这种组合进行的研究。
方法：在Medline/PubMed和Embase数据库中进行了文献检索，以寻找在转移性结直肠癌中使用氟尿苷/替吡草定联合贝伐单抗的系列。纳入荟萃分析的标准是报告的英语或法语，纳入20名或更多转移性结直肠癌患者在试验之外接受氟尿苷/替吡嗪联合贝伐单抗治疗，并包含有关反应率的信息，无进展生存期（PFS），总生存率（OS）。还收集了有关患者人口统计学和治疗不良反应的信息。
结果：有8个系列共437名患者符合meta分析的条件。进行的荟萃分析发现，总有效率（RR）为2.71％（95％置信区间（CI）：1.11-4.32％），疾病控制率（DCR）为59.63％（95％CI：52.06-67.21％）。总结PFS为4.56个月（95%CI：3.57-5.55个月），总OS为11.17个月(95%CI:10.15-12.19个月)。确定的常见不利影响反映了组合的两个组分的不利影响概况。
结论：目前的系统评价和荟萃分析报告了在临床试验之外的临床实践环境中，氟尿苷/替吡草定联合贝伐单抗在转移性结直肠癌高级治疗中的疗效。使用贝伐单抗发现对氟尿苷/替吡嘧啶的反应的预测性生物标志物将促进该治疗针对个体患者的定制以最大化临床益处。
方法：在Medline/PubMed和Embase数据库中进行了文献检索，以寻找在转移性结直肠癌中使用氟尿苷/替吡草定联合贝伐单抗的系列。纳入荟萃分析的标准是报告的英语或法语，纳入20名或更多转移性结直肠癌患者在试验之外接受氟尿苷/替吡嗪联合贝伐单抗治疗，并包含有关反应率的信息，无进展生存期（PFS），总生存率（OS）。还收集了有关患者人口统计学和治疗不良反应的信息。
结果：有8个系列共437名患者符合meta分析的条件。进行的荟萃分析发现，总有效率（RR）为2.71％（95％置信区间（CI）：1.11-4.32％），疾病控制率（DCR）为59.63％（95％CI：52.06-67.21％）。总结PFS为4.56个月（95%CI：3.57-5.55个月），总OS为11.17个月(95%CI:10.15-12.19个月)。确定的常见不利影响反映了组合的两个组分的不利影响概况。
结论：目前的系统评价和荟萃分析报告了在临床试验之外的临床实践环境中，氟尿苷/替吡草定联合贝伐单抗在转移性结直肠癌高级治疗中的疗效。使用贝伐单抗发现对氟尿苷/替吡嘧啶的反应的预测性生物标志物将促进该治疗针对个体患者的定制以最大化临床益处。
