Is There an Optimal Choice in Refractory Colorectal Cancer? A Network Meta-Analysis.
Clin Colorectal Cancer
; 19(2): 82-90.e9, 2020 06.
Article
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| MEDLINE
| ID: mdl-32192883
ABSTRACT
BACKGROUND:
In the absence of head-to-head comparison studies, the present network meta-analysis evaluated and compared the efficacy of 4 therapeutic alternatives for refractory colorectal cancer. MATERIALS ANDMETHODS:
The search focused on results from phase III randomized controlled trials. Separate (subgroup) network meta-analyses were conducted to obtain drug comparisons stratified by various patient characteristics. The principal outcome of interest was overall survival (OS).RESULTS:
No difference in OS was found between regorafenib and TAS-102. For a rectal primary location, TAS-102 conferred benefit versus placebo (hazard ratio [HR], 0.671), but regorafenib did not (HR, 0.950). For patients aged > 65 years, TAS-102 showed benefit versus placebo (HR, 0.579) but regorafenib did not (HR, 0.816). For patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 in the indirect comparison, regorafenib showed benefit versus placebo (HR, 0.687), as did TAS-102 (HR, 0.756) but with a lower advantage. For patients with RAS wild type not previously treated with anti-EGFR antibodies, panitumumab was the optimal choice for OS.CONCLUSIONS:
No differences in OS were found between regorafenib and TAS-102. Possible greater efficacy was found for TAS-102 compared with regorafenib for patients with a rectal primary location, ECOG PS > 0, and age > 65 years. In contrast, regorafenib showed possible greater effectiveness for patients with ECOG PS 0 and age < 65 years. In the RAS WT population, the anti-EGFR drug showed superiority with respect to TAS-102 and regorafenib. These results should be viewed as only exploratory, and further prospective studies are warranted to validate these data.Palavras-chave
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MEDLINE
Assunto principal:
Compostos de Fenilureia
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Piridinas
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Pirrolidinas
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Timina
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Neoplasias Colorretais
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Trifluridina
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Panitumumabe
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Antineoplásicos
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article