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Optimizing the Efficacy of First-Line Chemotherapy plus Bevacizumab in Metastatic Colorectal Cancer

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Abstract

Objective

To assess the efficacy and safety of first-line standard chemotherapy plus bevacizumab in metastatic colorectal cancer and to explore how to optimize therapeutic efficacy.

Design

First, meta-analysis and pooled analysis of three randomized, controlled trials were used to compare response rate (RR), progression-free survival (PFS), overall survival (OS), and grade 3 or 4 adverse events (G3/4AEs) of chemotherapy plus bevacizumab (n=1169) with those of chemotherapy alone (n=1148).Second, using six different regimens plus bevacizumab, the Spearman method was used to analyze the correlationbetween these regimens and OS. Finally, one-way ANOVA was used to compare OS in these regimens.

Results

Overall, chemotherapy plus bevacizumab increased RR by 3.8%, prolonged PFS by 3.0 months and OS by 3.3 months, and increased G3/4AEs by 7.6%. Significant differences were found in PFS (hazard ratio [HR] = 0.65; p = 0.000), OS (HR = 0.79; p = 0.000), and G3/4AEs (risk ratio= 1.12; p = 0.006). However, no statistical difference was found in RR (odds ratio = 1.32; p = 0.17). The optimal regimens with regard to mean OS were capecitabine and irinotecan (CAPIRI) plus bevacizumab (24.00 months) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX) plus bevacizumab (23.97 months).

Conclusion

First-line standard chemotherapy plus bevacizumab conferred a significant improvement in OS. In combination with bevacizumab, both CAPIRI and FOLFOX are favorable regimens, though further studies are needed to confirm these results.

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Acknowledgements

No sources of funding were used to conduct this study or prepare this manuscript. The authors have declared no conflicts of interest relevant to this work.

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Authors and Affiliations

  1. Postgraduate School, Fujian Medical University, Fuzhou, Fujian, People's Republic of China

    Shaotang Li

  2. Department of Colorectal and Anal Surgery, Affiliated Union Hospital of Fujian Medical University, Xinquan Road No. 29, Fuzhou, Fujian, People's Republic of China, 350001

    Pan Dr Chi

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  1. Shaotang Li
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Correspondence to Pan Dr Chi.

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Li, S., Dr Chi, P. Optimizing the Efficacy of First-Line Chemotherapy plus Bevacizumab in Metastatic Colorectal Cancer. BioDrugs 25, 43–50 (2011). https://doi.org/10.2165/11584680-000000000-00000

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