Background: Despite available meta-analyses, comparative efficacy and safety between bevacizumab and cetuximab-containing therapies in treating advanced colorectal cancer (CRC) still need to be elucidated.
Aim: This meta-analysis aimed to investigate the efficacy and grade 3-5 treatment-related adverse events (TARE3-5) of bevacizumab versus cetuximab in treating advanced CRC.
Method: A random sample of 400 patients aged 65 years or older from a clinical trial in four Swedish hospitals was selected. All patients' emergency department visits within 12 months after discharge were assessed with AT-HARM10. The main outcome measures were the percentage of successfully assessed visits for applicability and the interrater reliability (Cohen's kappa).
Results: Five RCTs and four observational cohort studies (2970 patients) were included. The bevacizumab-containing group was associated with a significantly lower ORR (risk ratio RR 0.91, 95% confidence interval CI 0.85-0.97, P = 0.006) than the cetuximab group. Bevacizumab was associated with significant superior DCR (RR 1.05, 95% CI 1.01 to 1.10, P = 0.02) and prolonged OS (hazard ratio HR 0.81, 95% CI 0.74-0.90, P < 0.0001) than cetuximab. No significant differences were observed for PFS (HR 0.97, 95% CI 0.92-1.03, P = 0.33) between the groups. Bevacizumab showed a lower rate of skin disorders (RR 0.10, 95% CI 0.02-0.43, P = 0.002) than cetuximab. There were no significant differences between the groups in the overall rate of TRAE3-5 (RR 0.92, 95% CI 0.84-1.01, P = 0.08). Subgroup analysis found a lower TARE3-5 rate in the bevacizumab group in RCTs (RR 0.91, 95% CI 0.83-1.00, P = 0.04).
Conclusion: Bevacizumab could increase DCR, prolong OS, and lower the skin disorder rate to treat patients with advanced CRC.
Keywords: Bevacizumab; Cetuximab; Colorectal cancer; Effectiveness; Meta-analysis; Safety.
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.