Second‐line chemotherapy in advanced and metastatic CRC

摘要: BACKGROUND Chemotherapy is widely used in colorectal cancer that has relapsed or failed to respond first-line treatment. OBJECTIVES To determine the efficacy of second-line chemotherapy for treatment advanced cancer. SEARCH STRATEGY We performed electronic searches following databases: MEDLINE (via PubMed; 1964-September 2007), EMBASE OVID; 1980-September 2007) and The Cochrane Library 2007, Issue 2. SELECTION CRITERIA Studies assessing (single combined with any chemotherapeutic agent, at dose number cycles) patients progressed, recurred did not chemotherapy. DATA COLLECTION AND ANALYSIS A descriptive analysis included trials was performed, due huge clinical heterogeneity between them. MAIN RESULTS Seven randomized controlled (RCTs) were included; one high quality, five moderate conference abstract. Second-line (irinotecan) showed benefits overall survival progression-free over Best Supportive Care (BSC) fluorouracil (5-FU). Fractionated administration proven be more beneficial toxic. Definitive results concerning risks oxaliplatin are pending publication. AUTHORS' CONCLUSIONS effective prolonging time progression Further RCTs needed assess optimal regimen.