评估耐火性转移性结直肠癌的第三线疗法:系统性审查和网络元分析
Celine Hoyek1, Syed Arsalan Ahmed Naqvi1, Oudai Sahvan1
1Department of Hematology and Oncology, Mayo Clinic, AZ, AZ, USA.
概括
特里弗鲁里丁/蒂皮拉西尔加贝瓦西祖马布显示,耐火性转移性结直肠癌 (mCRC) 的存活率有所改善. 其他治疗方法,如regorafenib和fruquintinib也是有效的,但组合治疗可能会提供更好的结果.
科学领域:
- 在瘤学瘤学.
- 临床药理学 临床药理学
- 生物统计学 生物统计学
背景情况:
- 耐火转移性结直肠癌 (mCRC) 提出了重大的生存挑战.
- 有限的直接比较数据存在于当前的治疗选择,如trifluridine/tipiracil (FTD-TPI) ±bevacizumab,regorafenib和fruquintinib.
研究的目的:
- 进行网络元分析 (NMA),比较耐火性mCRC的可用治疗方法的疗效和安全性.
- 为这些疗法提供基于整体生存 (OS) 和无进展生存 (PFS) 的比较排名.
主要方法:
- 对耐火mCRC的随机II/III期试验进行系统的文献搜索.
- 包括评估FTD-TPI的试验 ± 贝瓦西祖马布或拉穆西鲁马布,雷戈拉费尼布 (80mg或160mg) 和果丁尼布.
- 网络元分析以比较OS,PFS和毒性,与治疗排名的P-分数进行比较.
主要成果:
- 分析了11项低偏差风险的研究.
- 与最佳支持性护理 (BSC) 相比,FTD-TPI,Rego160和fruquintinib显示了改善的OS和PFS.
- FTD-TPI + bevacizumab 显示出优越的 OS 和 PFS 与 FTD-TPI + ramucirumab, fruquintinib, FTD-TPI 和 Rego160.0 相比. 在先前暴露于抗VEGF的患者中,FTD-TPI + 贝瓦齐祖马布仅显示了OS益处,而不是Rego160.0.
结论:
- 在耐火mCRC中,FTD-TPI与或没有贝瓦西祖马布,雷戈拉费尼布和果丁尼布都优于BSC.
- FTD-TPI + bevacizumab可能是耐火性mCRC的首选选择.
- 对于先前接触过抗VEGF的患者,FTD-TPI + 贝瓦西祖马布,果丁尼布或Rego80+的疗效相似.
关键词:
这是一个FTD-TPI.在FTD-TPI + 贝瓦西祖马布.FTD-TPI + ramucirumabb 的使用方法弗鲁昆丁尼布的使用方法网络元分析 网络元分析耐火的mCRC可以使用.雷戈拉费尼布的使用情况更多相关视频
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