PMID- 29680896
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1432-1262 (Electronic)
IS  - 0179-1958 (Linking)
VI  - 33
IP  - 8
DP  - 2018 Aug
TI  - Impact of the addition of bevacizumab, oxaliplatin, or irinotecan to
      fluoropyrimidin in the first-line treatment of metastatic colorectal cancer in
      elderly patients.
PG  - 1125-1130
LID - 10.1007/s00384-018-3053-3 [doi]
AB  - INTRODUCTION: The clinical benefit of double-front-line therapy (including
      oxaliplatin or irinotecan or bevacizumab plus 5-fluorouracil (5FU) or
      capecitabine) compared to monotherapy (5FU or capecitabine) in elderly (> 70
      years) patients with metastatic colorectal cancer (MCRC) is controversial. We
      performed a meta-analysis of published randomized studies. MATERIALS AND METHODS:
      The selection of the studies was carried out using PubMed with the following
      keywords: "metastatic colorectal cancer," "elderly," "oxaliplatin," "irinotecan,"
      "bevacizumab," "survival." The efficacy endpoints were overall survival (OS) and 
      progression-free survival (PFS). Hazard ratios (HRs) with their 95% confidence
      intervals (CIs) were collected from the studies and pooled. By convention, an HR 
      < 1 was a result in favor of biotherapy. RESULTS: This meta-analysis (MA)
      included ten studies: three assessing irinotecan (FFCD 2001-02, CAIRO, and an
      already published MA by Folprecht), three assessing oxaliplatin (FOCUS2, FFCD
      2000-05, and a published study by De Gramont), and four assessing bevacizumab
      (PRODIGE-20, AVEX, AGITG-MAX, and "AVF2192g" by Kabbinavar). Our MA included 1652
      patients (62% of men). Concerning age, we chose a cut-off of 70 years or a
      cut-off of 75 years, corresponding to the available data for each study. The
      performance index (PS) was 0-1 for about 90% of patients, with the exception of
      FFCD 2001-02 and FOCUS2 which included 30% of patients with PS2. Overall, the
      addition of bevacizumab to fluoropyrimidin statistically improves both OS and PFS
      (HR = 0.78; CI 0.63-0.96 and HR = 0.55; CI 0.44-0.67, respectively). The addition
      of oxaliplatin did not statistically improve OS (= 0.99; CI 0.85-1.17) but
      improves PFS (HR = 0.81; CI 0.67-0.97) as well as the addition of irinotecan (HR 
      = 1.01; CI 0.84-1.22 and HR = 0.82; CI 0.68-1.00, respectively). CONCLUSION: In
      previously untreated elderly patients with MCRC, the addition of bevacizumab to
      fluoropyrimidin appears more effective in terms of OS or PFS than the addition of
      oxaliplatin or irinotecan.
FAU - Landre, Thierry
AU  - Landre T
AD  - Geriatric Oncology Coordination Unit - UCOG 93, APHP, Rene Muret Hospital, HUPSSD
      - Universite Paris 13, Sevran, France. thierry.landre@aphp.fr.
AD  - FRancilian Oncogeriatric Group (FROG), Argenteuil, France.
      thierry.landre@aphp.fr.
FAU - Maillard, Emilie
AU  - Maillard E
AD  - Department of Biostatistics, Federation Francaise de Cancerologie Digestive,
      Dijon, France.
FAU - Taleb, Cherifa
AU  - Taleb C
AD  - Geriatric Oncology Coordination Unit - UCOG 93, APHP, Rene Muret Hospital, HUPSSD
      - Universite Paris 13, Sevran, France.
AD  - Oncology Department, APHP, Avicenne Hospital, HUPSSD - Universite Paris 13,
      Bobigny, France.
FAU - Ghebriou, Djamel
AU  - Ghebriou D
AD  - FRancilian Oncogeriatric Group (FROG), Argenteuil, France.
AD  - Department of Oncology, APHP, Tenon Hospital, Paris, France.
FAU - Guetz, Gaetan Des
AU  - Guetz GD
AD  - Oncology Department, APHP, Avicenne Hospital, HUPSSD - Universite Paris 13,
      Bobigny, France.
FAU - Zelek, Laurent
AU  - Zelek L
AD  - Geriatric Oncology Coordination Unit - UCOG 93, APHP, Rene Muret Hospital, HUPSSD
      - Universite Paris 13, Sevran, France.
AD  - Oncology Department, APHP, Avicenne Hospital, HUPSSD - Universite Paris 13,
      Bobigny, France.
FAU - Aparicio, Thomas
AU  - Aparicio T
AD  - Department of Biostatistics, Federation Francaise de Cancerologie Digestive,
      Dijon, France.
AD  - Gastroenterology Department, CHU Saint Louis, APHP, Universite Paris 7, Sorbonne 
      Paris Cite, Paris, France.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20180421
PL  - Germany
TA  - Int J Colorectal Dis
JT  - International journal of colorectal disease
JID - 8607899
RN  - 0 (Organoplatinum Compounds)
RN  - 04ZR38536J (Oxaliplatin)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 7673326042 (Irinotecan)
RN  - Q573I9DVLP (Leucovorin)
RN  - U3P01618RT (Fluorouracil)
RN  - XT3Z54Z28A (Camptothecin)
SB  - IM
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Bevacizumab/administration & dosage
MH  - Camptothecin/administration & dosage
MH  - Colorectal Neoplasms/*drug therapy
MH  - Disease-Free Survival
MH  - Female
MH  - Fluorouracil/administration & dosage
MH  - Humans
MH  - Irinotecan/administration & dosage
MH  - Leucovorin
MH  - Male
MH  - Organoplatinum Compounds
MH  - Oxaliplatin/administration & dosage
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Bevacizumab
OT  - Elderly
OT  - First line
OT  - Irinotecan
OT  - Meta-analysis
OT  - Metastatic colorectal cancer
OT  - Oxaliplatin
EDAT- 2018/04/24 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/04/23 06:00
PHST- 2018/04/09 00:00 [accepted]
PHST- 2018/04/24 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/04/23 06:00 [entrez]
AID - 10.1007/s00384-018-3053-3 [doi]
AID - 10.1007/s00384-018-3053-3 [pii]
PST - ppublish
SO  - Int J Colorectal Dis. 2018 Aug;33(8):1125-1130. doi: 10.1007/s00384-018-3053-3.
      Epub 2018 Apr 21.