Evidence map›Paper›PMID 29680896›Full record

SynthesisInternational journal of colorectal disease2018

Impact of the addition of bevacizumab, oxaliplatin, or irinotecan to fluoropyrimidin in the first-line treatment of metastatic colorectal cancer in elderly patients.

Thierry Landre, Emilie Maillard, Chérifa Taleb, Djamel Ghebriou, Gaetan Des Guetz, Laurent Zelek, Thomas Aparicio

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.3field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 20 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Targeted Therapies in Older Adults With Solid Tumors.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
    Review
  6. Article
  7. Article
  8. Review
  9. Treatment of Rectal Cancer in Older Adults.Current oncology reports · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Thierry LandreGeriatric Oncology Coordination Unit - UCOG 93, APHP, René Muret Hospital, HUPSSD - Université Paris 13, Sevran, France. thierry.landre@aphp.fr.
Emilie MaillardDepartment of Biostatistics, Fédération Française de Cancérologie Digestive, Dijon, France.
Chérifa TalebGeriatric Oncology Coordination Unit - UCOG 93, APHP, René Muret Hospital, HUPSSD - Université Paris 13, Sevran, France.
Djamel GhebriouFRancilian Oncogeriatric Group (FROG), Argenteuil, France.
Gaetan Des GuetzOncology Department, APHP, Avicenne Hospital, HUPSSD - Université Paris 13, Bobigny, France.
Laurent ZelekGeriatric Oncology Coordination Unit - UCOG 93, APHP, René Muret Hospital, HUPSSD - Université Paris 13, Sevran, France.
Thomas AparicioDepartment of Biostatistics, Fédération Française de Cancérologie Digestive, Dijon, France.
Université Sorbonne Paris Nord · FRFédération Francophone de Cancérologie Digestive · FRHôpital René-Muret · FRSorbonne Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe clinical benefit of double-front-line therapy (including oxaliplatin or irinotecan or bevacizumab plus 5-fluorouracil (5FU) or capecitabine) compared to monotherapy (5FU or capecitabine) in elderly (> 70 years) patients with metastatic colorectal cancer (MCRC) is controversial. We performed a meta-analysis of published randomized studies. MATERIALS AND

methodsThe selection of the studies was carried out using PubMed with the following keywords: "metastatic colorectal cancer," "elderly," "oxaliplatin," "irinotecan," "bevacizumab," "survival." The efficacy endpoints were overall survival (OS) and progression-free survival (PFS). Hazard ratios (HRs) with their 95% confidence intervals (CIs) were collected from the studies and pooled. By convention, an HR < 1 was a result in favor of biotherapy.

resultsThis meta-analysis (MA) included ten studies: three assessing irinotecan (FFCD 2001-02, CAIRO, and an already published MA by Folprecht), three assessing oxaliplatin (FOCUS2, FFCD 2000-05, and a published study by De Gramont), and four assessing bevacizumab (PRODIGE-20, AVEX, AGITG-MAX, and "AVF2192g" by Kabbinavar). Our MA included 1652 patients (62% of men). Concerning age, we chose a cut-off of 70 years or a cut-off of 75 years, corresponding to the available data for each study. The performance index (PS) was 0-1 for about 90% of patients, with the exception of FFCD 2001-02 and FOCUS2 which included 30% of patients with PS2. Overall, the addition of bevacizumab to fluoropyrimidin statistically improves both OS and PFS (HR = 0.78; CI 0.63-0.96 and HR = 0.55; CI 0.44-0.67, respectively). The addition of oxaliplatin did not statistically improve OS (= 0.99; CI 0.85-1.17) but improves PFS (HR = 0.81; CI 0.67-0.97) as well as the addition of irinotecan (HR = 1.01; CI 0.84-1.22 and HR = 0.82; CI 0.68-1.00, respectively).

conclusionIn previously untreated elderly patients with MCRC, the addition of bevacizumab to fluoropyrimidin appears more effective in terms of OS or PFS than the addition of oxaliplatin or irinotecan.

Indexed as

AgedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCamptothecinColorectal NeoplasmsDisease-Free SurvivalFemaleFluorouracilHumansIrinotecanLeucovorinMaleOrganoplatinum CompoundsOxaliplatinRandomized Controlled Trials as TopicBevacizumabCamptothecinFluorouracilIrinotecanLeucovorinOrganoplatinum CompoundsOxaliplatinBevacizumabElderlyFirst lineIrinotecanMeta-analysisMetastatic colorectal cancerOxaliplatin

Identifiers

PMID29680896
OpenAlexW2802614178

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.