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Network meta-analysis of first-line treatment of metastatic colorectal cancer with different chemotherapy combination regimens
- ZHONGGUO YAOFANG Vol. 36, Issue 17, Pages: 2197-2204(2025)
- 作者机构：
1.内蒙古医科大学内蒙古临床医学院，呼和浩特 010017
2.武警内蒙古总队医院日间病房，呼和浩特 010041
3.内蒙古自治区人民医院肿瘤内科，呼和浩特 010017
- 作者简介：
- 基金信息：
DOI：10.6039/j.issn.1001-0408.2025.17.20
CLC： R979.1;R735.3;R730.5Received：14 March 2025，
Revised：2025-07-30，
Accepted：31 July 2025，
Published：15 September 2025
- 稿件说明：
移动端阅览
张晓青,刘帅,张凯,等.不同化疗联合方案一线治疗转移性结直肠癌的网状Meta分析[J].中国药房,2025,36(17):2197-2204.
ZHANG Xiaoqing,LIU Shuai,ZHANG Kai,et al.Network meta-analysis of first-line treatment of metastatic colorectal cancer with different chemotherapy combination regimens[J].ZHONGGUO YAOFANG,2025,36(17):2197-2204.
张晓青,刘帅,张凯,等.不同化疗联合方案一线治疗转移性结直肠癌的网状Meta分析[J].中国药房,2025,36(17):2197-2204. DOI： 10.6039/j.issn.1001-0408.2025.17.20.
ZHANG Xiaoqing,LIU Shuai,ZHANG Kai,et al.Network meta-analysis of first-line treatment of metastatic colorectal cancer with different chemotherapy combination regimens[J].ZHONGGUO YAOFANG,2025,36(17):2197-2204. DOI： 10.6039/j.issn.1001-0408.2025.17.20.
摘要
目的
2
系统评价不同化疗联合方案用于转移性结直肠癌一线治疗的有效性和安全性。
方法
2
计算机检索PubMed、Cochrane Library、Embase、Web of Science数据库，收集用于转移性结直肠癌一线治疗的随机对照试验（RCT），检索时限为2000年1月1日至2025年2月16日。由2名研究者独立筛选文献、提取资料并评价研究的偏倚风险后，采用R4.4.3和Stata 17.0软件进行网状Meta分析。
结果
2
共纳入了28项RCT，包括16种干预措施。在延长患者无进展生存期（PFS）和总生存期（OS）方面，FOLFOX（5-氟尿嘧啶+奥沙利铂+亚叶酸钙方案）+西妥昔单抗排第1的概率最大。在提高客观缓解率（ORR）方面，FOLFOXIRI（5-氟尿嘧啶+奥沙利铂+伊立替康+亚叶酸钙方案）+贝伐珠单抗和FOLFOX+贝伐珠单抗+纳武利尤单抗排第1的概率最大；在≥3级不良反应发生率方面，FOLFOXIRI+帕尼单抗排第1的概率最大；对
KRAS
野生型进行亚组分析发现，在延长PFS和OS方面，FOLFIRI（5-氟尿嘧啶+伊立替康+亚叶酸钙方案）+帕尼单抗和FOLFIRI+贝伐珠单抗分别排第1的概率最大；在提高ORR方面，FOLFOXIRI+西妥昔单抗排第1的概率最大。
结论
2
在转移性结直肠癌的一线治疗中，FOLFOX联合靶向治疗在疗效和安全性方面更有优势，但需根据患者
KRAS
基因状态与肿瘤部位制定个体化治疗策略。
Abstract
OBJECTIVE
2
To systematically evaluate the efficacy and safety of different chemotherapy combination regimens for first-line treatment of metastatic colorectal cancer （mCRC）.
METHODS
2
PubMed， Cochrane Library， Embase and Web of Science were electronically searched to collect randomized controlled clinical trial （RCT） on first-line treatment for mCRC from January 1， 2000 to February 16， 2025. Two reviewers independently screened literature， extracted data and assessed the risk of bias of the included studies. Network meta-analysis was performed by using R4.4.3 and Stata 17.0 software.
RESULTS
2
A total of 28 RCTs， involving 16 intervention measures， were included. In terms of prolonging progression-free survival （PFS） and overall survival （OS）， FOLFOX （5-fluorouracil+oxaliplatin+calcium folinate regimen）+cetuximab had the highest probability of ranking first. In terms of improving objective response rate （ORR）， FOLFOXIRI （5-fluorouracil+oxaliplatin+irinotecan+calcium folinate regimen）+ bevacizumab and FOLFOX+bevacizumab+nivolumab had the highest probability of ranking first； in terms of the incidence of grade 3 or higher adverse reactions， FOLFOXIRI+panitumumab had the highest probability of ranking first； in subgroup analysis of
KRAS
wild-type patients， FOLFIRI （5-fluorouracil+irinotecan+calcium folinate regimen）+panitumumab and FOLFIRI+
bevacizumab had the highest probability of ranking first in terms of prolonging PFS and OS， respectively； in terms of ORR， FOLFOXIRI+ cetuximab had the highest probability of ranking first.
CONCLUSIONS
2
In first-line treatment for mCRC， FOLFOX combined with targeted therapy has advantages in terms of efficacy and safety. However， individualized treatment strategies should be formulated based on the
KRAS
gene status and tumor location of patients.
关键词
Keywords
references
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