Open AccessThe efficacy of adding targeted agents to neoadjuvant therapy for locally advanced rectal cancer patients: a meta‐analysis
Author(s) -
Zhong Xi,
Wu Zhonghua,
Gao Peng,
Shi Jinxin,
Sun Jingxu,
Guo Zhexu,
Wang Zhenning,
Song Yongxi
Publication year - 2018
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1298
Subject(s) - medicine , bevacizumab , cetuximab , oncology , colorectal cancer , neoadjuvant therapy , meta analysis , targeted therapy , kras , chemotherapy , cancer , breast cancer
Patients with locally advanced rectal cancer ( LARC ) are at tremendous risk of metastatic diseases. To improve the prognoses of LARC patients, the efficacy of adding targeted agents to neoadjuvant therapy has been investigated by many researchers but remains controversial. A literature search of relevant databases was conducted through December 2016, 804 studies were identified and 32 investigations were ultimately included. A total of 1196 patients from 31 cohorts of 29 studies were eligible for quantitative synthesis in this single‐arm setting meta‐analysis. As pathologic complete response ( pCR ) shows promise as a prognosis indicator, we focused on pCR rates to evaluate whether adding targeted agents to neoadjuvant therapies improves the outcome of LARC patients. In our study, we revealed pooled estimates of pCR of 27% (95% CI , 21–34%) and 14% (95% CI , 9–21%) for bevacizumab‐relevant cohorts and cetuximab‐relevant cohorts, respectively. The safety of adding targeted agents to neoadjuvant therapy was also evaluated by pooling the data of Grade 3/4 toxicity. In conclusion, our study revealed that adding bevacizumab to the neoadjuvant therapy regimens provides appreciable pCR for LARC patients. Meanwhile, the efficacy of cetuximab remains inconclusive, RCT s with larger scale and better study design that stress more on mutational status are needed.