Tumor Biology

, Volume 36, Issue 5, pp 3361–3369 | Cite as

Meta-analysis comparing the safety and efficacy of metastatic colorectal cancer treatment regimens, capecitabine plus irinotecan (CAPIRI) and 5-fluorouracil/leucovorin plus irinotecan (FOLFIRI)

  • Hong-hua Ding
  • Wei-dong Wu
  • Tao Jiang
  • Jun Cao
  • Zheng-yi Ji
  • Jia-hua Jin
  • Jing-jue Wang
  • Wei-feng Song
  • Li-wei Wang
Research Article
  • 364 Downloads

Abstract

The relative efficacy and safety of first-line metastatic colorectal cancer (mCRC) treatment regimens, capecitabine with irinotecan (CAPIRI) and 5-fluorouracil/leucovorin plus irinotecan (FOLFIRI), are not well defined. We identified and subsequently examined seven independent, randomized controlled clinical trials, performing a meta-analysis to compare these two treatment regimens. Using Medline, EMBASE, Cochrane Library (CENTRAL), and the American Society of Clinical Oncology Annual Meeting to search available literature until February 2014, we identified seven studies comparing safety and efficacy of CAPIRI and FOLFIRI in mCRC patients. These studies were pooled and evaluated for rates of progression-free survival (PFS), objective response rate (ORR), overall survival (OS), and diarrhea. CAPIRI and FOLFIRI demonstrated similar efficacy outcomes, though CAPIRI was associated with a higher incidence of diarrhea. CAPIRI and FOLFIRI are equally effective options for first-line treatment of mCRC.

Keywords

CAPIRI FOLFIRI Metastatic colorectal cancer Meta-analysis 

Notes

Funding source

This work was supported by China Medical Fund.

Conflicts of interest

None

Supplementary material

13277_2014_2970_Fig7_ESM.gif (14 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

13277_2014_2970_Fig8_ESM.gif (14 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

13277_2014_2970_Fig9_ESM.gif (17 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

13277_2014_2970_Fig10_ESM.gif (16 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

13277_2014_2970_Fig11_ESM.gif (56 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

13277_2014_2970_Fig12_ESM.gif (54 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

13277_2014_2970_Fig13_ESM.gif (54 kb)
Supplementary figure 1

Evaluation of meta-analysis sensitivity by the ‘leave-one-out’ approach. Sensitivity analysis was employed to examine the influence of individual studies on pooled estimates of (A) progression-free survival; (B) overall survival; (C) overall response rate; (D) diarrhea rate; (E) nausea rate; (F) febrile neutropenia rate; (G) neutropenia rate. Abbreviations: CI, confidence interval. (GIF 13 kb)

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Supplementary figure 2

Funnel plots for (A) overall response rate; (B) diarrhea rate; (C) nausea rate; (D) febrile neutropenia rate; (E) neutropenia rate. X-axis represents the logOR; Y-axis represents the SE of logOR. Gray circles represent published articles. Abbreviations: OR, odds ratio; SE, standard error. (GIF 9 kb)

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Supplementary figure 2

Funnel plots for (A) overall response rate; (B) diarrhea rate; (C) nausea rate; (D) febrile neutropenia rate; (E) neutropenia rate. X-axis represents the logOR; Y-axis represents the SE of logOR. Gray circles represent published articles. Abbreviations: OR, odds ratio; SE, standard error. (GIF 9 kb)

13277_2014_2970_Fig16_ESM.gif (48 kb)
Supplementary figure 2

Funnel plots for (A) overall response rate; (B) diarrhea rate; (C) nausea rate; (D) febrile neutropenia rate; (E) neutropenia rate. X-axis represents the logOR; Y-axis represents the SE of logOR. Gray circles represent published articles. Abbreviations: OR, odds ratio; SE, standard error. (GIF 9 kb)

13277_2014_2970_Fig17_ESM.gif (48 kb)
Supplementary figure 2

Funnel plots for (A) overall response rate; (B) diarrhea rate; (C) nausea rate; (D) febrile neutropenia rate; (E) neutropenia rate. X-axis represents the logOR; Y-axis represents the SE of logOR. Gray circles represent published articles. Abbreviations: OR, odds ratio; SE, standard error. (GIF 9 kb)

13277_2014_2970_Fig18_ESM.gif (48 kb)
Supplementary figure 2

Funnel plots for (A) overall response rate; (B) diarrhea rate; (C) nausea rate; (D) febrile neutropenia rate; (E) neutropenia rate. X-axis represents the logOR; Y-axis represents the SE of logOR. Gray circles represent published articles. Abbreviations: OR, odds ratio; SE, standard error. (GIF 9 kb)

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  • Hong-hua Ding
    • 1
  • Wei-dong Wu
    • 2
  • Tao Jiang
    • 2
  • Jun Cao
    • 2
  • Zheng-yi Ji
    • 2
  • Jia-hua Jin
    • 1
  • Jing-jue Wang
    • 1
  • Wei-feng Song
    • 1
  • Li-wei Wang
    • 1
  1. 1.Department of Oncology, Shanghai First People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
  2. 2.Department of Surgery, Shanghai First People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China

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