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

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.

journal_name

Int J Clin Oncol

journal_title

International journal of clinical oncology

authors

Colloca GA,Venturino A,Guarneri D

doi

10.1007/s10147-019-01405-1

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

231-240

issue

3

eissn

1341-9625

issn

1437-7772

pii

10.1007/s10147-019-01405-1

journal_volume

24

pub_type

杂志文章,meta分析

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