Department of gastrointestinal surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Sci Rep. 2018 Jan 11;8(1):510. doi: 10.1038/s41598-017-19001-6.
Panitumumab and bevacizumab have been widely used in combination with chemotherapy for patients with wild type RAS metastatic colorectal cancer (mCRC). Whether panitumumab or bevacizumab was the optimal option remained controversial. Thus, we conducted a meta-anaylsis to evaluate chemotherapy plus panitumumab (C + P) versus chemotherapy plus bevacizumab (C + B) in wild type RAS mCRC. Electronic databases including PubMed, Embase, and Web of Science, Cochrane Library, ClinicalTrials.gov, were searched. This meta-analysis estimated the progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and adverse events (AEs). Three randomized controlled trials with a total number of 577 patients were included. In wild type RAS population, PFS [hazard ratio (HR) = 0.96; 95% confidence interval (CI), 0.76 to 1.15] and OS (HR = 0.90; 95% CI, 0.54 to 1.27) and ORR [relative ratio (RR) = 2.06; 95% CI, 0.86 to 4.90] appeared similar between the two treatments, the incidence of AEs slightly increased (RR = 1.16; 95% CI 1.08 to 1.26). In conclusion, there was insufficient evidence to precisely conclude that combination treatment of C + P had an improved efficacy compared with C + B. Further large-scale and better-designed clinical trials are still needed to evaluate the combination treatment of C + P in patients with wild type RAS mCRC.
帕尼单抗和贝伐珠单抗已广泛与化疗联合用于野生型 RAS 转移性结直肠癌（mCRC）患者。帕尼单抗或贝伐珠单抗哪个是最佳选择仍存在争议。因此，我们进行了一项荟萃分析，以评估化疗联合帕尼单抗（C+P）与化疗联合贝伐珠单抗（C+B）在野生型 RAS mCRC 中的疗效。检索了 PubMed、Embase、Web of Science、Cochrane Library、ClinicalTrials.gov 等电子数据库。该荟萃分析评估了无进展生存期（PFS）、总生存期（OS）、总缓解率（ORR）和不良事件（AEs）。纳入了 3 项随机对照试验，共 577 例患者。在野生型 RAS 人群中，PFS[风险比（HR）=0.96；95%置信区间（CI），0.76 至 1.15]和 OS（HR=0.90；95%CI，0.54 至 1.27）以及 ORR[相对比（RR）=2.06；95%CI，0.86 至 4.90]在两种治疗方法之间似乎相似，AEs 的发生率略有增加（RR=1.16；95%CI 1.08 至 1.26）。总之，没有足够的证据确切地得出结论，C+P 联合治疗与 C+B 相比具有更好的疗效。仍需要进一步的大规模、设计更好的临床试验来评估 C+P 联合治疗在野生型 RAS mCRC 患者中的疗效。
