title: Bevacizumab in combination with first-line chemotherapy in patients with metastatic colorectal cancer: a meta-analysis.
abstract: Bevacizumab plays an important role in the treatment of patients with metastatic colorectal cancer (mCRC). The aim of this study is to assemble current RCTs to analyze efficacy of adding bevacizumab to the most used combination first-line chemotherapy in mCRC patients. PubMed, Web of Science, the Cochrane Library and Embase were systematically searched. Our primary endpoint was overall survival (OS), progression-free survival (PFS) and secondary endpoint was overall response rate (ORR). Hazard ratios (HRs) for PFS and OS and risk ratio (RR) for ORR were extracted from each trial. All these above were performed using a random-effects model and statistics was performed in StataSE 12.0. Seven randomized controlled studies aggregating 3264 patients were enrolled in our meta-analysis. OS, PFS and ORR were performed using a random-effects model. A therapeutic effect advantage was showed in Bevacizumab added to first-line chemotherapy with higher OS (HR=0.67; 95% CI=0.61-0.72; P=0.000), PFS (HR=0.67; 95% CI=0.61-0.72; P=0.000) compared with chemotherapy alone. Chemotherapy plus bevacizumab increased ORR (38.42% vs. 33.44%), showing statistically difference (RR=1.17, 95% CI=1.06-1.28, P=0.001). Our meta-analysis shows that the addition of bevacizumab to first-line regimens can be beneficial in terms of OS, PFS and ORR compared with chemotherapy alone.
authors.affiliation: Department of Oncological Radiotherapy, People's Hospital of Quzhou, Zhejiang, China - hehj15@163.com.
authors.forename: W
authors.initials: W
authors.lastname: Hu
authors.forename: W S
authors.initials: WS
authors.lastname: Xu
authors.forename: X F
authors.initials: XF
authors.lastname: Liao
authors.forename: H J
authors.initials: HJ
authors.lastname: He
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D018572:Disease-Free Survival; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab