Anti‐angiogenic therapies for metastatic colorectal cancer

摘要: Background Angiogenesis inhibitors have been developed to block tumour angiogenesis and target vascular endothelial cells. While some of them already approved by the health authorities are successfully integrated into patient care, many others still under development, clinical value this approach has be established. Objectives To assess efficacy toxicity targeted anti-angiogenic therapies, in addition chemotherapy, patients with metastatic colorectal cancer. Primary endpoints both progression-free overall survival. Response rates, secondary resectability were endpoints. Comparisons first-line chemotherapy combination inhibitor, same without inhibitor; second-line inhibitor. Search methods We searched Cochrane Central Register Controlled Trials, MEDLINE, as well proceedings from ECCO, ESMO ASCO until November 2008. In addition, reference lists trials scanned, experts field drug manufacturers contacted obtain further information. Selection criteria Randomized controlled on drugs cancer (MCRC). Data collection analysis Data analysis was performed, according a previously published protocol. Because individual data not provided, aggregate had used for analysis. Summary statistics primary hazard ratios (HR's) their 95% confidence intervals. Main results At present, eligible first line meta-analysis available bevacizumab (5 including 3101 patients) vatalanib (1 trial which included 1168 patients). The HR´s PFS (0.61, CI 0.45 - 0.83) OS (0.81, 0.73 0.90) comparison or bevacizumab, confirms significant benefits favour treated bevacizumab. However, effect shows heterogeneity. For benefit (HR 0.61, 0.51 0.73) 0.75, 0.63-0.89) demonstrated single, randomized trial. differences treatment-related deaths 60-day mortality significant, higher incidences grade III/IV hypertension, arterial thrombembolic events gastrointestinal perforations observed valatanib, currently showed non-significant OS. Authors' conclusions The prolongs first-and therapy.