Evidence map›Paper›PMID 31574891›Full record

SynthesisMedicine2019

The efficacy and safety of irinotecan ± bevacizumab compared with oxaliplatin ± bevacizumab for metastatic colorectal cancer: A meta-analysis.

Jiali Dai, Yuetong Chen, Yang Gong, Jingsun Wei, Xiaowen Cui, Hualin Yu, Wenjing Zhao, Dongying Gu, Jinfei Chen

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 28% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
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

9 authors at 1 institution in 1 country.

Jiali DaiDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Yuetong ChenDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Yang GongDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Jingsun WeiDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Xiaowen CuiDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Hualin YuDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Wenjing ZhaoDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Dongying GuDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Jinfei ChenDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University.
Nanjing Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIrinotecan (IRI)-based and oxaliplatin (OXA)-based regimens are available for the treatment of metastatic colorectal cancer (mCRC). Several studies have published inconsistent results in their comparisons of the efficacy and toxicity of IRI ± bevacizumab and OXA ± bevacizumab. This meta-analysis was performed to evaluate the efficacy and safety of these 2 regimens in patients with mCRC.

methodsWe searched several databases to identify relevant studies, including PubMed, EMBASE, and the Cochrane Controlled Trials Register. The primary endpoints were overall survival (OS) and time to progression (TTP). The secondary comparisons were overall response rate (ORR) and toxicity. In addition, the hazard ratio (HR) or risk ratio (RR) values with their corresponding 95% confidence intervals (CIs) were extracted from these studies.

resultsPooled data of 13 studies demonstrated no significant differences in OS (HR = 0.96, 95% CI: 0.86-1.08, P = .53) and TTP (HR = 0.88, 95% CI: 0.72-1.08, P = .24) between the 2 groups. However, the ORR (RR = 0.87, 95% CI: 0.78-0.97, P = .02) was clearly improved in the OXA ± bevacizumab arm. Higher incidences of grade 3/4 nausea (RR = 1.63, 95% CI: 1.28-2.07, P < .001), vomiting (RR = 1.40, 95% CI: 1.09-1.81, P = .01), diarrhea (RR = 1.44, 95% CI: 1.23-1.70, P < .001), and anemia (RR = 4.13, 95% CI: 2.75-6.22, P < .001) were observed in the IRI group. However, the incidences of grade 3/4 neutropenia (RR = 0.75, 95% CI: 0.68-0.83, P < .001), thrombocytopenia (RR = 0.43, 95% CI: 0.26-0.73, P = .002), and paresthesia/neurological disturbances (RR = 0.04, 95% CI: 0.02-0.07, P < .001) were higher in the OXA group.

conclusionThis meta-analysis confirmed that the OXA ± bevacizumab regimen as a maintenance therapy significantly improved the ORR in patients with mCRC. Exhibiting strong efficacy and safety, the OXA and OXA plus bevacizumab regimens are preferred as first-line treatments for mCRC.

Indexed as

AdultAgedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabColorectal NeoplasmsFemaleHumansIrinotecanMaleMiddle AgedNeoplasm MetastasisOxaliplatinTreatment OutcomeBevacizumabIrinotecanOxaliplatin

Identifiers

PMID31574891
PMCPMC6775432
OpenAlexW2977084560

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.