Anti-angiogenic Agents Combined With Chemotherapy For Patients With Advanced Colorectal Cancer:A Meta-analysis

Objective: The efficacy and safety of antiangiogenic agents combined with chemotherapy in advanced colorectal cancer are systematically evaluated by Meta analysisMethods: The relevant studies about the treatment of advanced colorectal cancer with antiangiogenic agents combined with chemotherapy were incorporated into by searching Cochrane Library,Embase,PubMed which published before July 2017.The methodological quality of included studies was evaluated for Eighteen studys,then Using RevMan 5.3 software for Meta analys is.Results: 18 randomized controlled studies were included,with a total sample size of 1,0053 patients.The results of Meta analysis showed that anti-angiogenic agents combined w ith chemotherapy group was better than chemotherapy alone or placebo group in overall survival(HR=0.87,95% CI: 0.82 ~0.91,P<0.00001),progression-free survival(HR=0.73,95% CI: 0.65~0.81,P<0.00001),partial response(OR=1.63,95% CI: 1.26~2.12,P=0.0003),response rate(OR=1.50,95% CI: 1.33~1.69,P< 0.00001).In terms of safety,The incidence of thrombocytopenia(OR=2.80,95% CI: 0.03~3.87,P<0.00001),fatigue(OR=1.91,95% CI:1.49~2.44,P<0.00001),febrile neutropenia(OR=1.63,95% CI:1.07~2.47,P=0.02),hypertension(OR=6.27,95% CI:4.87~8.07,P<0.00001),bleeding(OR=1.70,95% CI: 1.19~2.43,P=0.004),Proteinuria(OR=6.40,95% CI: 3.73~10.96,P<0.00001),arteriovenous thromboembolism(OR=1.57,95% CI: 1.28~1.92,P<0.0001),Peripheral neuropathy(OR=1.41,95% CI:1.02~1.95,P=0.04),gastrointestinal perforation(OR=2.33,95% CI:1.17~4.65,P=0.02),stomatitis and ulceration(OR=2.67,95% CI:1.97~3.62,P<0.00001),diarrhea(OR=1.61,95% CI:1.25~2.09,P=0.0002),Palmar-plantar erythrodysesthesia syndrome(OR=3.18,95% CI: 2.22~ 4.54,P<0.00001),neutropenia(OR=1.74,95% CI: 1.53~ 1.96,P<0.00001)in combination with antiangiogenic drugs was significantly different from that in chemotherapy alone or placebo groups.Conclusion:Anti-angiogenesis drugs combined with chemotherapy can signif icantly increase survival benef its for advanced clorectal neoplasms,yet could increase the incidence of adverse reactions.