Network meta-analysis of first-line treatment of metastatic colorectal cancer with different chemotherapy combination regimens
- VernacularTitle:不同化疗联合方案一线治疗转移性结直肠癌的网状Meta分析
- Author:
Xiaoqing ZHANG
1
;
Shuai LIU
2
;
Kai ZHANG
1
;
Beibei JI
3
;
Wei LUAN
3
Author Information
1. Inner Mongolia Clinical Medical College，Inner Mongolia Medical University，Hohhot 010017，China
2. Day-care Unit，Inner Mongolia Armed Police Hospital，Hohhot 010041，China
3. Dept. of Medical Oncology，Inner Mongolia People’s Hospital，Hohhot 010017，China
- Publication Type:Journal Article
- Keywords:
colorectal cancers;
network meta-analysis
- From:
China Pharmacy
2025;36(17):2197-2204
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of different chemotherapy combination regimens for first-line treatment of metastatic colorectal cancer （mCRC）. METHODS PubMed， Cochrane Library， Embase and Web of Science were electronically searched to collect randomized controlled clinical trial （RCT） on first-line treatment for mCRC from January 1， 2000 to February 16， 2025. Two reviewers independently screened literature， extracted data and assessed the risk of bias of the included studies. Network meta-analysis was performed by using R4.4.3 and Stata 17.0 software. RESULTS A total of 28 RCTs， involving 16 intervention measures， were included. In terms of prolonging progression-free survival （PFS） and overall survival （OS）， FOLFOX （5-fluorouracil+oxaliplatin+calcium folinate regimen）+cetuximab had the highest probability of ranking first. In terms of improving objective response rate （ORR）， FOLFOXIRI （5-fluorouracil+oxaliplatin+irinotecan+calcium folinate regimen）+ bevacizumab and FOLFOX+bevacizumab+nivolumab had the highest probability of ranking first； in terms of the incidence of grade 3 or higher adverse reactions， FOLFOXIRI+panitumumab had the highest probability of ranking first； in subgroup analysis of KRAS wild-type patients， FOLFIRI （5-fluorouracil+irinotecan+calcium folinate regimen）+panitumumab and FOLFIRI+bevacizumab had the highest probability of ranking first in terms of prolonging PFS and OS， respectively； in terms of ORR， FOLFOXIRI+ cetuximab had the highest probability of ranking first. CONCLUSIONS In first-line treatment for mCRC， FOLFOX combined with targeted therapy has advantages in terms of efficacy and safety. However， individualized treatment strategies should be formulated based on the KRAS gene status and tumor location of patients.
