A network meta-analysis on the efficacy of sixteen targeted drugs in combination with chemotherapy for treatment of advanced/metastatic colorectal cancer.
OBJECTIVE
A network meta-analysis was conducted comparing the short-term efficacies of 16 targeted drugs in combination with chemotherapy for treatment of advanced/metastatic colorectal cancer (CRC).


RESULTS
Twenty-seven RCTs were ultimately incorporated into this network meta-analysis. Compared with chemotherapy alone, bevacizumab + chemotherapy, panitumumab + chemotherapy and conatumumab + chemotherapy had higher PR rate. Bevacizumab + chemotherapy, cetuximab + chemotherapy, panitumumab + chemotherapy, trebananib + chemotherapy and conatumumab + chemotherapy had higher ORR rate in comparison to chemotherapy alone. Furthermore, bevacizumab + chemotherapy had higher DCR rate than chemotherapy alone. The results of our cluster analysis showed that chemotherapy combined with bevacizumab, cetuximab, panitumumab, conatumumab, ganitumab, or brivanib + cetuximab had better efficacies for the treatment of advanced/metastatic CRC in comparison to chemotherapy alone.


METHODS
Electronic databases were comprehensively searched for potential and related randomized controlled trials (RCTs). Direct and indirect evidence were incorporated for evaluation of stable disease (SD), progressive disease (PD), complete response (CR), partial response (PR), disease control rate (DCR) and overall response ratio (ORR) by calculating odds ratio (OR) and 95% confidence intervals (CI), and using the surface under the cumulative ranking curve (SUCRA).


CONCLUSIONS
These results indicated that bevacizumab + chemotherapy, panitumumab + chemotherapy, conatumumab + chemotherapy and brivanib + cetuximab + chemotherapy may have better efficacies for the treatment of advanced/metastatic CRC.
Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China.
Dan-Zeng
DZ
Ba-Sang
Department of Gastric Cancer and Soft-Tissue Sarcoma Surgery, Fudan university Shanghai Cancer Center, Shanghai 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P. R. China.
Zi-Wen
ZW
Long
Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China.
Hao
H
Teng
Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China.
Xu-Peng
XP
Zhao
Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China.
Jian
J
Qiu
Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China.
Ming-Shan
MS
Li
D000409:Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000627:therapeutic use; D000068818:Cetuximab / Q000008:administration & dosage / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004358:Drug Therapy; D006801:Humans; D009362:Neoplasm Metastasis; D000077544:Panitumumab; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014227:Triazines; C554537:conatumumab; D000068258:Bevacizumab; D000077544:Panitumumab; C545764:ganitumab; C509922:brivanib; D000409:Alanine; D000068818:Cetuximab
chemotherapy; colorectal cancer; network meta-analysis; randomized controlled trial; targeted drug