title: Validity of combination active specific immunotherapy for colorectal cancer: a meta-analysis of 2993 patients.
abstract: OBJECTIVE
  The aim of this study was to investigate whether active specific immunotherapy (ASI) is able to demonstrate therapeutic efficacy against colorectal cancer.
  
  
  METHODS
  We conducted a systematic review of published papers from MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Wanfang Database, the China Science and Technology Periodical Database and China Journal Net. Published data were extracted independently by two authors who used predefined database templates. The effects of ASI were compared with those of surgery alone, and a pooled analysis was performed with the use of the data from random- or fixed-effect models.
  
  
  RESULTS
  Twelve trials matched our inclusion criteria (n = 2993, including 1842 control subjects). The overall analysis showed a significant survival benefit [1-, 2-, 3-, 4-, 5-, 6- and 7-year overall survival (OS), P < 0.05; 10-year OS, P < 0.001] in favor of ASI immunotherapy combined with surgery, but there was not an improvement in the 8- or 9-year OS (P > 0.05). The disease-free survival (DFS) rate was improved after the combination of ASI immunotherapy (2-, 3-, 5- and 10-year DFS, P < 0.05), but no significant improvement was noted for the 1-, 4-, 6-, 7-, 8- or 9-year DFS (P > 0.05). In addition, the disease-specific survival (DSS) was improved at some time points after the combination of ASI immunotherapy and surgery (2-, 3-, 4-, 5- and 6-year DSS, P < 0.05, but not the 1-, 7-, 8- or 9-year DSS, P > 0.05). An improved 2-, 3-, 4-, 5- and 6-year recurrence-free interval (RFI) (P < 0.05) was also observed in patients who received ASI therapy, but this was not observed for the 1-year RFI (P > 0.05). Furthermore, an analysis of the recurrence-free survival (RFS) showed that it was significantly increased in the ASI plus surgery group (1-, 2-, 3-, 4-, 5- and 6-year RFS, P < 0.001). The funnel plots showed that the analyses were relatively reliable and the publication bias was small.
  
  
  CONCLUSIONS
  The combination of ASI immunotherapy and surgery was superior in prolonging the overall survival time and enhancing the recurrence-free survival rate compared with surgery alone.
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Jun-Xia
authors.initials: JX
authors.lastname: Cao
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhang
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Jin-Long
authors.initials: JL
authors.lastname: Liu
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Jun-Li
authors.initials: JL
authors.lastname: Li
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Yi-Shan
authors.initials: YS
authors.lastname: Liu
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Bei-Lei
authors.initials: BL
authors.lastname: Xu
authors.affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, China. Electronic address: zhxuwang@vip.163.com.
authors.forename: Zheng-Xu
authors.initials: ZX
authors.lastname: Wang
mesh_terms: D015179:Colorectal Neoplasms / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D015996:Survival Rate
keywords: Newcastle disease virus; active specific immunotherapy; bacillus Calmette-Guérin; colorectal cancer; meta-analysis