title: Efficacy of Bevacizumab in the First-Line Treatment of Patients with RAS Mutations Metastatic Colorectal Cancer: a Systematic Review and Network Meta-Analysis.
abstract: OBJECTIVE
  Whether patients with RAS mutation metastatic colorectal cancer (mCRC) obtain benefits from bevacizumab added to first-line chemotherapy remains unclear.
  
  
  METHODS
  PubMed, Cochrane Systematic Reviews, the Cochrane Collaboration Central Register of Controlled Clinical Trials, ClinicalTrials.gov, and the American Society of Clinical Oncology and European Society for Medical Oncology databases were searched to identify abstracts for randomized controlled trials (RCTs) evaluating the efficacy of bevacizumab for the first-line treatment of patients with RAS mutations mCRC from inception to the end of April 2016. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were estimated.
  
  
  RESULTS
  Ten eligible papers reporting six RCTs were included. In the network meta-analysis of patients with RAS mutations, bevacizumab + chemotherapy prolonged PFS compared with chemotherapy alone (HR 0.75, 95% CI 0.51-1.10), but the difference was not statistically significant. Bevacizumab + chemotherapy did not prolong OS compared with chemotherapy alone (HR 1.10, 95% CI 0.73-1.66).
  
  
  CONCLUSIONS
  There was insufficient evidence to definitively state that patients with RAS mutations mCRC could benefit from bevacizumab combined with chemotherapy as first-line treatment.
authors.affiliation: Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital &amp; Institute, Shenyang, PR China.
authors.forename: Mingyi
authors.initials: M
authors.lastname: Zhou
authors.forename: Ping
authors.initials: P
authors.lastname: Yu
authors.forename: Jinglei
authors.initials: J
authors.lastname: Qu
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhou
authors.forename: Lingyu
authors.initials: L
authors.lastname: Fu
authors.forename: Jingdong
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000068258:Bevacizumab / Q000494:pharmacology / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D018572:Disease-Free Survival; D006801:Humans; D009154:Mutation / Q000235:genetics*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics*
chemical_list: D000068258:Bevacizumab; D018631:ras Proteins