Oncotarget

Research Papers:

The role of targeted agents in the adjuvant treatment of colon cancer: a meta-analysis of randomized phase III studies and review

Bum Jun Kim, Jae Ho Jeong, Jung Han Kim, Hyeong Su Kim _ and Hyun Joo Jang

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Oncotarget. 2017; 8:31112-31118. https://doi.org/10.18632/oncotarget.16091

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Abstract

Bum Jun Kim1,*, Jae Ho Jeong2,*, Jung Han Kim1, Hyeong Su Kim1, Hyun Joo Jang3

1Department of Internal Medicine, Division of Hemato-Oncology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea

2Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea

3Department of Internal Medicine, Division of Gastroenterology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Hwasung, Republic of Korea

*These authors equally contributed to this work as first authors

Correspondence to:

Jung Han Kim, email: harricil@hotmail.com

Hyeong Su Kim, email: nep2n@hallym.or.kr

Keywords: colon cancer, adjuvant treatment, targeted agent, bevacizumab, cetuximab

Received: February 13, 2017     Accepted: March 02, 2017     Published: March 10, 2017

ABSTRACT

There has been debate as to whether targeted agents have beneficial effect when added to adjuvant chemotherapy for patient with colon cancer. We conducted this meta-analysis to investigate the role of targeted agents in the adjuvant treatment of colon cancer. We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library databases. We included phase III trials with the data of disease-free survival (DFS) and adverse events (AEs) of adjuvant treatment with targeted agents. From 5 eligible studies, a total of 9,991 patients with resected colon cancer were included in the meta-analysis of hazard ratio (HR) for 3-year DFS and odds ratio (OR) for grade 3 or higher AEs. The addition of targeted agents showed no improvement of 3-year DFS, compared to standard adjuvant chemotherapy alone (HR = 1.04 [95% confidence interval (CI), 0.96–1.13], P = 0.31). In the subgroup analysis according to the type of targeted agents, neither bevacizumab (HR = 1.03 [95% CI, 0.88–1.21], P = 0.72) nor cetuximab (HR = 1.11 [95% CI, 0.94–1.31], P = 0.22) was associated with improvement of DFS. Moreover, targeted agents significantly increased grade 3 or higher AEs (OR = 1.73 [95% CI, 1.21–2.46], P = 0.003) and treatment-related death (OR = 2.15 [95% CI, 1.16–3.99], P = 0.02). In conclusion, this meta-analysis demonstrates that the addition of targeted agents to standard adjuvant chemotherapy results in no improvement of DFS with increased severe AEs and treatment-related death in patients with resected colon cancer.


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