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

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Tumor Biology

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.

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Funding source

This work was supported by China Medical Fund.

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Authors and Affiliations

  1. Department of Oncology, Shanghai First People’s Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai, 200080, People’s Republic of China

    Hong-hua Ding, Jia-hua Jin, Jing-jue Wang, Wei-feng Song & Li-wei Wang

  2. Department of Surgery, Shanghai First People’s Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai, 200080, People’s Republic of China

    Wei-dong Wu, Tao Jiang, Jun Cao & Zheng-yi Ji

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  1. Hong-hua Ding
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Correspondence to Li-wei Wang.

Additional information

Hong-hua Ding, MD, and Wei-dong Wu, MD, are co-first authors.

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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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Ding, Hh., Wu, Wd., Jiang, T. et al. Meta-analysis comparing the safety and efficacy of metastatic colorectal cancer treatment regimens, capecitabine plus irinotecan (CAPIRI) and 5-fluorouracil/leucovorin plus irinotecan (FOLFIRI). Tumor Biol. 36, 3361–3369 (2015). https://doi.org/10.1007/s13277-014-2970-1

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