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International Journal of Clinical Oncology

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01-03-2019 | Bevacizumab | Review Article

Early tumor shrinkage after first-line medical treatment of metastatic colorectal cancer: a meta-analysis

Authors: Giuseppe A. Colloca, Antonella Venturino, Domenico Guarneri

Published in: International Journal of Clinical Oncology | Issue 3/2019

Abstract

Background

Early tumor shrinkage (ETS) is a response-related endpoint of clinical trials of chemotherapy (CHT) of patients with metastatic colorectal cancer (mCRC). It identifies a dimensional reduction of tumor size by at least 20–30% after 6–8 weeks of CHT.

Methods

A literature search of randomized trials of systemic treatment including CHT with or without antiangiogenics or anti-EGFR inhibitors in patients with mCRC has been conducted, and studies reporting the results of the relationship of ETS with overall survival (OS) and progression-free survival (PFS) were selected.

Results

Twelve trials, including 3117 patients, have been included; all data were retrospective and only 72% of the enrolled patients have been evaluated for ETS. Two meta-analyses, each including 20 study cohorts from the selected 12 trials, reported a strong relationship of ETS with OS (HR 0.62; CIs 0.55–0.69) and of ETS with PFS (HR 0.66; CIs 0.60–0.73). However, both meta-analyses displayed a high level of heterogeneity. Among nine possible moderators, three variables (median age, surgery of metastases, and publication year) were able to explain at least a part of this heterogeneity.

Conclusion

ETS is a simple and interesting intermediate endpoint for clinical practice and future trials of medical treatments of patients with mCRC, but a large prospective analysis and validation are mandatory.

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Title: Early tumor shrinkage after first-line medical treatment of metastatic colorectal cancer: a meta-analysis
Authors: Giuseppe A. Colloca
Antonella Venturino
Domenico Guarneri
Publication date: 01-03-2019
Publisher: Springer Singapore
Keywords: Bevacizumab
Cetuximab
Cytostatic Therapy
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Clinical Oncology / Issue 3/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-019-01405-1

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