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Meta-analysis comparing maintenance strategies with continuous therapy and complete chemotherapy-free interval strategies in the treatment of metastatic colorectal cancer
- Source :
- Oncotarget
- Publication Year :
- 2015
-
Abstract
- There is as yet no consensus as to the best choice among the three treatment options (maintenance, complete chemotherapy-free intervals [CFIs], and continuous) for metastatic colorectal cancer (CRC). We performed a meta-analysis of six trials (N = 2, 454 patients) to compare the safety and efficacy of those three treatment strategies. Maintenance appeared to offer an advantage over CFI with respect to progression-free survival (PFS) (hazard ratio [HR]: 0.53, 95% confidence interval [CI], 0.40-0.69). PFS and overall survival (OS) were comparable between the maintenance and continuous strategies (HR: 1.18, 95% CI, 0.96-1.46; HR: 1.05, 95% CI, 0.98-1.27, respectively), as was OS between the maintenance and CFI strategies (HR: 0.84; 95% CI, 0.70-1.00). The incidence of grade 3/4 toxicity, including neutropenia, neuropathy, hand-foot syndrome and fatigue, was lower with maintenance than with continuous therapy. A maintenance regimen utilizing bevacizumab-based doublets appeared to confer a slight advantage over bevacizumab monotherapy with respect to PFS (P = 0.011). Maintenance appeared to reduce cumulative grade 3/4 toxicity as compared to the continuous strategy, while showing comparable efficacy. Bevacizumab-based doublets appeared to be of particular value in patients with metastatic CRC.
- Subjects :
- 0301 basic medicine
Oncology
Male
Time Factors
Colorectal cancer
optimal maintenance strategies
law.invention
0302 clinical medicine
Randomized controlled trial
systematic review
law
Risk Factors
Antineoplastic Combined Chemotherapy Protocols
Odds Ratio
Medicine
Neoplasm Metastasis
Aged, 80 and over
Clinical Trials as Topic
Hazard ratio
Middle Aged
Bevacizumab
Treatment Outcome
030220 oncology & carcinogenesis
randomized controlled trials
Disease Progression
Female
pooled analysis
Colorectal Neoplasms
medicine.drug
Adult
medicine.medical_specialty
Neutropenia
Disease-Free Survival
Drug Administration Schedule
Maintenance Chemotherapy
03 medical and health sciences
Internal medicine
Humans
grade 3 to 4 toxicities
Survival analysis
Aged
business.industry
medicine.disease
Survival Analysis
Confidence interval
Surgery
Regimen
030104 developmental biology
Clinical Research Paper
business
Subjects
Details
- ISSN :
- 19492553
- Volume :
- 7
- Issue :
- 22
- Database :
- OpenAIRE
- Journal :
- Oncotarget
- Accession number :
- edsair.doi.dedup.....ba066a26b5e43089072d0f2f72be5cb3