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International Journal of Clinical Oncology
Erschienen in: International Journal of Clinical Oncology 3/2019

04.02.2019 | Review Article

Early tumor shrinkage after first-line medical treatment of metastatic colorectal cancer: a meta-analysis

verfasst von: Giuseppe A. Colloca, Antonella Venturino, Domenico Guarneri

Erschienen in: International Journal of Clinical Oncology | Ausgabe 3/2019

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Abstract

Background

Early tumor shrinkage (ETS) is a response-related endpoint of clinical trials of chemotherapy (CHT) of patients with metastatic colorectal cancer (mCRC). It identifies a dimensional reduction of tumor size by at least 20–30% after 6–8 weeks of CHT.

Methods

A literature search of randomized trials of systemic treatment including CHT with or without antiangiogenics or anti-EGFR inhibitors in patients with mCRC has been conducted, and studies reporting the results of the relationship of ETS with overall survival (OS) and progression-free survival (PFS) were selected.

Results

Twelve trials, including 3117 patients, have been included; all data were retrospective and only 72% of the enrolled patients have been evaluated for ETS. Two meta-analyses, each including 20 study cohorts from the selected 12 trials, reported a strong relationship of ETS with OS (HR 0.62; CIs 0.55–0.69) and of ETS with PFS (HR 0.66; CIs 0.60–0.73). However, both meta-analyses displayed a high level of heterogeneity. Among nine possible moderators, three variables (median age, surgery of metastases, and publication year) were able to explain at least a part of this heterogeneity.

Conclusion

ETS is a simple and interesting intermediate endpoint for clinical practice and future trials of medical treatments of patients with mCRC, but a large prospective analysis and validation are mandatory.
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Metadaten
Titel
Early tumor shrinkage after first-line medical treatment of metastatic colorectal cancer: a meta-analysis
verfasst von
Giuseppe A. Colloca
Antonella Venturino
Domenico Guarneri
Publikationsdatum
04.02.2019
Verlag
Springer Singapore
Erschienen in
International Journal of Clinical Oncology / Ausgabe 3/2019
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01405-1

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