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The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis

BACKGROUND: Patients with locally advanced rectal cancer (LARC) are more likely to suffer local recurrence and distant metastases, contributing to worse prognoses. Considering the provided dramatic reduction of local recurrences, neoadjuvant CRT (nCRT) followed by curative resection with total mesor...

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Autores principales: Zhou, Yue, Guo, Zhexu, Wu, Zhonghua, Shi, Jinxin, Zhou, Cen, Sun, Jie, Hidasa, Iko, Lu, Xuefei, Lu, Chong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Neoplasia Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704460/
https://www.ncbi.nlm.nih.gov/pubmed/33248411
http://dx.doi.org/10.1016/j.tranon.2020.100964
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author Zhou, Yue
Guo, Zhexu
Wu, Zhonghua
Shi, Jinxin
Zhou, Cen
Sun, Jie
Hidasa, Iko
Lu, Xuefei
Lu, Chong
author_facet Zhou, Yue
Guo, Zhexu
Wu, Zhonghua
Shi, Jinxin
Zhou, Cen
Sun, Jie
Hidasa, Iko
Lu, Xuefei
Lu, Chong
author_sort Zhou, Yue
collection PubMed
description BACKGROUND: Patients with locally advanced rectal cancer (LARC) are more likely to suffer local recurrence and distant metastases, contributing to worse prognoses. Considering the provided dramatic reduction of local recurrences, neoadjuvant CRT (nCRT) followed by curative resection with total mesorectal excision (TME) and adjuvant chemotherapy has been established as standard therapy for LARC patients. However, the efficacy of adding bevacizumab in neoadjuvant therapy, especially in induction therapy-containing nCRT for LARC patients remains uncertain. MATERIALS: PubMed, Embase, and Web of Science were searched to retrieve records on the application of bevacizumab in a neoadjuvant setting for LARC patients. The endpoints of interest were pCR and the rates of patients suffering Grade 3/4 bevacizumab-specific adverse events, namely bleeding, wound healing complications, and gastrointestinal perforation. RESULTS: 29 cohorts covering 1134 subjects were included in this systematic review. The pooled pCR rate for bevacizumab-relevant cohorts was 21% (95% confidence interval (95% CI), 17–25%; I(2) = 61.8%), the pooled estimates of Grade 3/4 bleeding, Grade 3/4 wound healing complication, Grade 3/4 gastrointestinal perforation were 1% (95% CI, 0–3%; I(2) = 0%), 2% (95% CI, 1–5%; I(2) = 4.7%), and 2% (95% CI, 0–5%; I(2) = 0%), respectively. CONCLUSION: The addition of bevacizumab in the nCRT, especially in the TNT, for LARC patients provides promising efficacy and acceptable safety. However, the results should be interpreted cautiously due to the small amount of relevant data and need further confirmation by future studies.
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spelling pubmed-77044602020-12-09 The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis Zhou, Yue Guo, Zhexu Wu, Zhonghua Shi, Jinxin Zhou, Cen Sun, Jie Hidasa, Iko Lu, Xuefei Lu, Chong Transl Oncol Original Research BACKGROUND: Patients with locally advanced rectal cancer (LARC) are more likely to suffer local recurrence and distant metastases, contributing to worse prognoses. Considering the provided dramatic reduction of local recurrences, neoadjuvant CRT (nCRT) followed by curative resection with total mesorectal excision (TME) and adjuvant chemotherapy has been established as standard therapy for LARC patients. However, the efficacy of adding bevacizumab in neoadjuvant therapy, especially in induction therapy-containing nCRT for LARC patients remains uncertain. MATERIALS: PubMed, Embase, and Web of Science were searched to retrieve records on the application of bevacizumab in a neoadjuvant setting for LARC patients. The endpoints of interest were pCR and the rates of patients suffering Grade 3/4 bevacizumab-specific adverse events, namely bleeding, wound healing complications, and gastrointestinal perforation. RESULTS: 29 cohorts covering 1134 subjects were included in this systematic review. The pooled pCR rate for bevacizumab-relevant cohorts was 21% (95% confidence interval (95% CI), 17–25%; I(2) = 61.8%), the pooled estimates of Grade 3/4 bleeding, Grade 3/4 wound healing complication, Grade 3/4 gastrointestinal perforation were 1% (95% CI, 0–3%; I(2) = 0%), 2% (95% CI, 1–5%; I(2) = 4.7%), and 2% (95% CI, 0–5%; I(2) = 0%), respectively. CONCLUSION: The addition of bevacizumab in the nCRT, especially in the TNT, for LARC patients provides promising efficacy and acceptable safety. However, the results should be interpreted cautiously due to the small amount of relevant data and need further confirmation by future studies. Neoplasia Press 2020-11-25 /pmc/articles/PMC7704460/ /pubmed/33248411 http://dx.doi.org/10.1016/j.tranon.2020.100964 Text en © 2020 The Authors. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Zhou, Yue
Guo, Zhexu
Wu, Zhonghua
Shi, Jinxin
Zhou, Cen
Sun, Jie
Hidasa, Iko
Lu, Xuefei
Lu, Chong
The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis
title The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis
title_full The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis
title_fullStr The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis
title_full_unstemmed The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis
title_short The efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: A systematic review and meta-analysis
title_sort efficacy and safety of adding bevacizumab in neoadjuvant therapy for locally advanced rectal cancer patients: a systematic review and meta-analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704460/
https://www.ncbi.nlm.nih.gov/pubmed/33248411
http://dx.doi.org/10.1016/j.tranon.2020.100964
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