PRISMA flow diagram for included studies.
<div><p>Background</p><p>The optimal second-line systemic treatment for metastatic colorectal cancer (mCRC) is inconclusive.</p><p>Methods</p><p>We searched PubMed, Web of Science, EMBASE, and Cochrane Library for RCTs comparing second-line systemic tr...
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2024
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| _version_ | 1852024163145875456 |
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| author | Chengyu Sun (291981) |
| author2 | Enguo Fan (1371660) Luqiao Huang (20469258) Zhengguo Zhang (3284823) |
| author2_role | author author author |
| author_facet | Chengyu Sun (291981) Enguo Fan (1371660) Luqiao Huang (20469258) Zhengguo Zhang (3284823) |
| author_role | author |
| dc.creator.none.fl_str_mv | Chengyu Sun (291981) Enguo Fan (1371660) Luqiao Huang (20469258) Zhengguo Zhang (3284823) |
| dc.date.none.fl_str_mv | 2024-12-23T18:36:52Z |
| dc.identifier.none.fl_str_mv | 10.1371/journal.pone.0313278.g001 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/figure/PRISMA_flow_diagram_for_included_studies_/28085301 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Medicine Cell Biology Genetics Biotechnology Cancer patient &# 8217 metastatic colorectal cancer grade &# 8805 cumulative ranking curve 2 %); whereas 0 %, 81 therapeutic effect may 4 %, 74 rcts comparing second among multiple second 1 %, respectively subgroup analyses showed rct </ p panitumumab ranked among bayesian network meta line systemic treatments line systemic treatment 1 %, subgroup analyses network meta line treatments 4 %) 1 %) optimal second best second 44 second xlink "> type population systematic review survival outcomes significantly different significant advantage searched pubmed physiological state optimum intervention mutant populations mutant population involving 16 free survival february 3 cochrane library bevacizumab may ae ). adverse events 925 patients 7 %). 3ae ), |
| dc.title.none.fl_str_mv | PRISMA flow diagram for included studies. |
| dc.type.none.fl_str_mv | Image Figure info:eu-repo/semantics/publishedVersion image |
| description | <div><p>Background</p><p>The optimal second-line systemic treatment for metastatic colorectal cancer (mCRC) is inconclusive.</p><p>Methods</p><p>We searched PubMed, Web of Science, EMBASE, and Cochrane Library for RCTs comparing second-line systemic treatments for mCRC from the inception of each database up to February 3, 2024. Markov Chain Monte Carlo (MCMC) technique was used in this network meta-analysis (NMA) to generate the direct and indirect comparison results among multiple treatments in progression-free survival (PFS), overall response rate (ORR), overall survival (OS), complete response (CR), partial response (PR), grade 3 and above adverse events (Grade ≥ 3AE), and any adverse events (Any AE). The surface under the cumulative ranking curve (SUCRA) was adopted to evaluate the probability of each treatment being the optimum intervention. Subgroup analyses were performed based on the RAS gene status.</p><p>Results</p><p>A total of 47 randomized controlled trials were included, involving 16,925 patients and 44 second-line systemic treatments. In improving OS, FOLFOX + Bevacizumab + Erlotinib exhibited significant superiority (SUCRA:92.7%). In improving PFS, Irinotecan + CMAB009 (SUCRA:86.4%) had advantages over other treatments. FOLFIRI + Trebananib (SUCRA:88.1%) had a significant advantage in improving ORR. Among multiple second-line treatments, the SUCRA values of FOLFOX + Bevacizumab in PFS, OS, ORR, and PR were 83.4%, 74.0%, 81.1%, and 86.1%, respectively, and the safety was not significantly different from other interventions. Subgroup analyses showed that FOLFIRI + Bevacizumab + panitumumab ranked among the top in survival outcomes in the RAS-mutant population (OS SUCRA: 87.9%; PFS SUCRA: 70.2%); whereas in the RAS-wild-type population, FOLFIRI + Bevacizumab significantly improved survival outcomes (OS SUCRA: 73.2%; PFS SUCRA: 65.1%).</p><p>Conclusion</p><p>For most people, FOLFOX + Bevacizumab may be the best second-line systemic treatment regimen for mCRC. For RAS-mutant populations, FOLFIRI + Bevacizumab + Panitumumab is recommended. However, the therapeutic effect may be affected by the patient’s physiological state, and clinicians should apply it based on actual conditions.</p></div> |
| eu_rights_str_mv | openAccess |
| id | Manara_e796796f8e3dfcb7fb9017e8f73639a4 |
| identifier_str_mv | 10.1371/journal.pone.0313278.g001 |
| network_acronym_str | Manara |
| network_name_str | ManaraRepo |
| oai_identifier_str | oai:figshare.com:article/28085301 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | PRISMA flow diagram for included studies.Chengyu Sun (291981)Enguo Fan (1371660)Luqiao Huang (20469258)Zhengguo Zhang (3284823)MedicineCell BiologyGeneticsBiotechnologyCancerpatient &# 8217metastatic colorectal cancergrade &# 8805cumulative ranking curve2 %); whereas0 %, 81therapeutic effect may4 %, 74rcts comparing secondamong multiple second1 %, respectivelysubgroup analyses showedrct </ ppanitumumab ranked amongbayesian network metaline systemic treatmentsline systemic treatment1 %,subgroup analysesnetwork metaline treatments4 %)1 %)optimal secondbest second44 secondxlink ">type populationsystematic reviewsurvival outcomessignificantly differentsignificant advantagesearched pubmedphysiological stateoptimum interventionmutant populationsmutant populationinvolving 16free survivalfebruary 3cochrane librarybevacizumab mayae ).adverse events925 patients7 %).3ae ),<div><p>Background</p><p>The optimal second-line systemic treatment for metastatic colorectal cancer (mCRC) is inconclusive.</p><p>Methods</p><p>We searched PubMed, Web of Science, EMBASE, and Cochrane Library for RCTs comparing second-line systemic treatments for mCRC from the inception of each database up to February 3, 2024. Markov Chain Monte Carlo (MCMC) technique was used in this network meta-analysis (NMA) to generate the direct and indirect comparison results among multiple treatments in progression-free survival (PFS), overall response rate (ORR), overall survival (OS), complete response (CR), partial response (PR), grade 3 and above adverse events (Grade ≥ 3AE), and any adverse events (Any AE). The surface under the cumulative ranking curve (SUCRA) was adopted to evaluate the probability of each treatment being the optimum intervention. Subgroup analyses were performed based on the RAS gene status.</p><p>Results</p><p>A total of 47 randomized controlled trials were included, involving 16,925 patients and 44 second-line systemic treatments. In improving OS, FOLFOX + Bevacizumab + Erlotinib exhibited significant superiority (SUCRA:92.7%). In improving PFS, Irinotecan + CMAB009 (SUCRA:86.4%) had advantages over other treatments. FOLFIRI + Trebananib (SUCRA:88.1%) had a significant advantage in improving ORR. Among multiple second-line treatments, the SUCRA values of FOLFOX + Bevacizumab in PFS, OS, ORR, and PR were 83.4%, 74.0%, 81.1%, and 86.1%, respectively, and the safety was not significantly different from other interventions. Subgroup analyses showed that FOLFIRI + Bevacizumab + panitumumab ranked among the top in survival outcomes in the RAS-mutant population (OS SUCRA: 87.9%; PFS SUCRA: 70.2%); whereas in the RAS-wild-type population, FOLFIRI + Bevacizumab significantly improved survival outcomes (OS SUCRA: 73.2%; PFS SUCRA: 65.1%).</p><p>Conclusion</p><p>For most people, FOLFOX + Bevacizumab may be the best second-line systemic treatment regimen for mCRC. For RAS-mutant populations, FOLFIRI + Bevacizumab + Panitumumab is recommended. However, the therapeutic effect may be affected by the patient’s physiological state, and clinicians should apply it based on actual conditions.</p></div>2024-12-23T18:36:52ZImageFigureinfo:eu-repo/semantics/publishedVersionimage10.1371/journal.pone.0313278.g001https://figshare.com/articles/figure/PRISMA_flow_diagram_for_included_studies_/28085301CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/280853012024-12-23T18:36:52Z |
| spellingShingle | PRISMA flow diagram for included studies. Chengyu Sun (291981) Medicine Cell Biology Genetics Biotechnology Cancer patient &# 8217 metastatic colorectal cancer grade &# 8805 cumulative ranking curve 2 %); whereas 0 %, 81 therapeutic effect may 4 %, 74 rcts comparing second among multiple second 1 %, respectively subgroup analyses showed rct </ p panitumumab ranked among bayesian network meta line systemic treatments line systemic treatment 1 %, subgroup analyses network meta line treatments 4 %) 1 %) optimal second best second 44 second xlink "> type population systematic review survival outcomes significantly different significant advantage searched pubmed physiological state optimum intervention mutant populations mutant population involving 16 free survival february 3 cochrane library bevacizumab may ae ). adverse events 925 patients 7 %). 3ae ), |
| status_str | publishedVersion |
| title | PRISMA flow diagram for included studies. |
| title_full | PRISMA flow diagram for included studies. |
| title_fullStr | PRISMA flow diagram for included studies. |
| title_full_unstemmed | PRISMA flow diagram for included studies. |
| title_short | PRISMA flow diagram for included studies. |
| title_sort | PRISMA flow diagram for included studies. |
| topic | Medicine Cell Biology Genetics Biotechnology Cancer patient &# 8217 metastatic colorectal cancer grade &# 8805 cumulative ranking curve 2 %); whereas 0 %, 81 therapeutic effect may 4 %, 74 rcts comparing second among multiple second 1 %, respectively subgroup analyses showed rct </ p panitumumab ranked among bayesian network meta line systemic treatments line systemic treatment 1 %, subgroup analyses network meta line treatments 4 %) 1 %) optimal second best second 44 second xlink "> type population systematic review survival outcomes significantly different significant advantage searched pubmed physiological state optimum intervention mutant populations mutant population involving 16 free survival february 3 cochrane library bevacizumab may ae ). adverse events 925 patients 7 %). 3ae ), |