Evidence map›Paper›PMID 32219509›Full record

SynthesisInternational journal of colorectal disease2020

A systematic review of salvage therapies in refractory metastatic colorectal cancer.

Fausto Petrelli, Gianluca Perego, Antonio Ghidini, Michele Ghidini, Karen Borgonovo, Cinzia Scolari, Renata Nozza, Valentina Rampulla, Antonio Costanzo, Antonio Varricchio and 3 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 37% 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

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. 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

13 authors at 7 institutions in 1 country.

Fausto PetrelliOncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy. faupe@libero.it.
Gianluca PeregoPharmacy Unit, San Raffaele Hospital, Milan, Italy.
Antonio GhidiniOncology Unit, Casa di Cura Igea, Milan, Italy.
Michele GhidiniOncology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Karen BorgonovoOncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy.
Cinzia ScolariPharmacy Unit, ASST Bergamo Ovest, Treviglio, BG, Italy.
Renata NozzaPharmacy Unit, ASST Bergamo Ovest, Treviglio, BG, Italy.
Valentina RampullaSurgical Oncology Unit, ASST Bergamo Ovest, Treviglio, BG, Italy.
Antonio CostanzoSurgical Oncology Unit, ASST Bergamo Ovest, Treviglio, BG, Italy.
Antonio VarricchioSurgical Oncology Unit, ASST Bergamo Ovest, Treviglio, BG, Italy.
Emanuele RausaSurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.
Filippo PietrantonioOncology Unit, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy.
Alberto ZaniboniOncology Unit, Fondazione Poliambulanza, Brescia, Italy.
Azienda Socio Sanitaria Territoriale di Bergamo OvestAzienda Ospedaliera Treviglio · ITCasa di Cura Columbus · ITFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico · ITFondazione IRCCS Istituto Nazionale dei Tumori · ITFondazione Poliambulanza Istituto Ospedaliero · ITOspedale Papa Giovanni XXIII · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEstablished that the only approved agents in previously treated metastatic colorectal cancer (CRC) are trifluoridine/tipiracil and regorafenib, we conducted a systematic review of all the published phase 2-3 trials, with the scope to evaluate the benefit of any later-line regimens in refractory metastatic CRC.

methodsPhase 2-3 studies that enrolled patients with stage IV disease receiving salvage therapies for refractory CRC were identified using electronic databases (Pubmed, EMBASE, and Cochrane Library). Clinical outcomes were pooled using a point estimates for the weighted values of median overall survival (OS), progression-free survival (PFS), response rate (ORR), stable disease rate (SD), and 6-month and 1-year OS.

resultsOverall, 7556 patients were included from 67 studies (n = 70 arms). Overall, the pooled ORR and SD were 15.4% (95% CI 13-18%) and 36.9% (95% CI 33.5-40.6%). Median PFS, 6-month and 1-year OS, and median OS were 3.2 (95% CI 2.9-3.3) months, 65.4% (95% CI 61.9-68.8%), 36% (95% CI 32.3-39.9%) and 8.8 (95% CI 8.3-9.2) months. Overall survival was different in the monochemotherapy, polychemotherapy, chemotherapy + targeted therapy, and targeted therapy alone arms (7.6, 9.5, 10.3, and 7.9 months, respectively, P for difference = 0.01). Median PFS were respectively 2.3, 3.9, 3.8, and 2.6, respectively (P for difference < 0.01).

conclusionsOverall, combination therapy (polychemotherapy with or without targeted agents) is associated with a higher control of disease and better outcome than approved agents. Treatment, if possible, should be personalized according to the patients' conditions, physician preference and molecular profile of disease.

Indexed as

Salvage TherapyAgedAged, 80 and overColorectal NeoplasmsHumansMiddle AgedProgression-Free SurvivalTreatment OutcomeChemotherapyColorectal cancerRefractoryReviewThird line

Identifiers

PMID32219509
OpenAlexW3013737176

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.