Carcinoembryonic antigen reduction after medical treatment in patients with metastatic colorectal cancer: a systematic review and meta-analysis
- 22.01.2019
- Original Article
Erschienen in:
- Verfasst von
- Giuseppe Antonio Colloca
- Antonella Venturino
- Domenico Guarneri
- Erschienen in
- International Journal of Colorectal Disease | Ausgabe 4/2019
Abstract
Purpose
The introduction of new drugs and multimodal treatments for the management of patients with metastatic colorectal cancer (mCRC) has reduced the importance of time-to-event endpoints and reported the attention on the response-related endpoints. Furthermore, the prognostic role of the surgical scores before the resection of metastases has not been confirmed for multimodal treatments. The purpose of this research is to perform a meta-analysis of the studies that evaluated the relationship between carcinoembryonic antigen (CEA) response and outcome in patients with mCRC receiving systemic chemotherapy.
Methods
A systematic review of the literature on two databases and a selection of studies that evaluated the relationship between CEA response and outcome were performed according to predefined criteria. After, three meta-analyses were carried out on the selected studies, each for each outcome variable.
Results
Nineteen studies have been selected. Fourteen studies (1475 patients) have documented a close association between radiological response and CEA response (odds ratio (OR), 9.03; confidence intervals (CIs), 5.14–15.87; I2 statistic (I2), 72%). Four studies have reported a longer progression-free survival for patients with a CEA response (hazard ratio (HR), 0.73; CIs, 0.64–0.83; I2, 23%). Finally, 10 studies (13 study cohorts) have shown a strong relationship between CEA response and overall survival (OS) (HR, 0. 62; CIs, 0.55–0.70; I2, 35%).
Conclusions
CEA response merits further investigation as a surrogate endpoint of clinical trials of first-line medical therapy of patients with mCRC, and should be studied as a prognostic factor for those patients who are candidates for multimodal treatment strategies.
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- Titel
- Carcinoembryonic antigen reduction after medical treatment in patients with metastatic colorectal cancer: a systematic review and meta-analysis
- Verfasst von
-
Giuseppe Antonio Colloca
Antonella Venturino
Domenico Guarneri
- Publikationsdatum
- 22.01.2019
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
International Journal of Colorectal Disease / Ausgabe 4/2019
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262 - DOI
- https://doi.org/10.1007/s00384-018-03230-w
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