瑞戈非尼、呋喹替尼、TAS-102治疗转移性结直肠癌的疗效及安全性的Meta分析

Meta-analysis of the efficacy and safety of regorafenib, furaquintinib, and TAS- 102 in the treatment of metastatic colorectal cancer

目的 系统评价瑞戈非尼、呋喹替尼、曲氟尿苷替匹嘧啶(TAS-102)治疗转移性结直肠癌(mCRC)的疗效及安全性,以有效指导临床医师进行合理用药。方法 利用计算机检索Cochrane Library、PubMed、Google school、Embase、中国知网等数据库,检索时限为建库至2022年12月30日。收集瑞戈非尼、呋喹替尼、TAS-102治疗mCRC疗效及安全性的随机对照试验,采用Cochrane 6.1评分系统对文献进行系统评估,提取总生存期(OS)、无进展生存期(PFS)、客观缓解率(ORR)、疾病控制率(DCR)及药品不良反应(ADR)信息,采用RevMan 5.3、ITC软件进行分析。结果 纳入文献6篇,其中瑞戈非尼相关文献2篇,包括瑞戈非尼组641例,对照组323例;呋喹替尼相关文献2篇,包括呋喹替尼组325例,对照组162例;TAS-102相关文献2篇,包括TAS-102组805例,对照组401例。Meta分析结果显示,瑞戈非尼组、呋喹替尼组、TAS-102组的OS、PFS长于对照组,DCR高于对照组(P<0.01);瑞戈非尼组、呋喹替尼组、TAS-102组的ORR与对照组比较差异无统计学意义(P>0.05);瑞戈非尼组、呋喹替尼组3级以上ADR发生率高于对照组(P<0.05),TAS-102组3级以上ADR发生率与对照组比较差异无统计学意义(P>0.05)。瑞戈非尼组、呋喹替尼组、TAS-102组的OS、ORR、DCR及3级以上ADR发生率比较差异均无统计学意义(P>0.05),但呋喹替尼组的PFS长于TAS-102组(P<0.05)。结论 瑞戈非尼、呋喹替尼、TAS-102作为治疗mCRC的新型化疗药物,其临床抗癌活性均较为可观,且均存在ADR,但呋喹替尼的PFS更优。

Objective To systematically evaluate the efficacy and safety of regorafenib,furazinotinib,and TAS-102 in the treatment of metastatic colorectal cancer(mCRC),in order to effectively guide clinicians to rationalize the use of drugs.Methods Cochrane Library,PubMed,Google school,Embase,CNKI databases were searched by computer with the time limit was from the establishment of the database to December 30,2022.Randomized controlled trials on the efficacy and safety of regorafenib,furaquintinib,and TAS-102 in the treatment of mCRC were collected,and the literature was systematically evaluated using the Cochrane 6.1 scoring system to extract the data related to overall survival(OS),progression-free survival(PFS),objective remission rate(ORR),disease control rate(DCR),and adverse drug reactions(ADR)data were analyzed by RevMan 5.3 and ITC software.Results Six articles were included,two articles related to regorafenib,including 641 cases in the regorafenib group and 323 cases in the control group.Two articles related to furaquinotinib,including 325 cases in the furaquinotinib group and 162 cases in the control group.Two articles related to TAS-102,including 805 cases in the TAS-102 group and 401 cases in the control group.The results of Meta-analysis showed that the OS and PFS of the regorafenib group,the furaquintinib group,and the TAS-102 group were longer than those of the control group,and the DCR was higher than that of the control group(P<0.01).The incidence of ADR above grade 3 in the regorafenib group and the furaquintinib group were higher than that in the control group(P<0.05),and the difference in the incidence of ADR above grade 3 in the TAS-102 group was not statistically significant when compared with that in the control group(P>0.05).The difference in OS,ORR,DCR and the incidence of ADR above grade 3 in the regorafenib,furaquintinib and TAS-102 groups were not statistically significant when compared with the control group(P>0.05),but the PFS in the furaquintinib group was longer than that in the TAS-102 group(P<0.05).Conclusion Regorafenib,furaquintinib and TAS-102 as new chemotherapeutic agents for mCRC,all of them have considerable clinical anticancer activity,and all of them have ADR,but furaquintinib has better PFS.