Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis

BackgroundConcurrent chemoradiotherapy (CRT) is the preferred treatment strategy for inoperable esophageal cancer (EC). However, the effect of CRT needs to be improved.MethodsThis study comprehensively analyzed targeted agents combined with CRT for the treatment of EC by a network meta-analysis. The...

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Autores principales:	Peng Liu, Guo-Fei Wang, Hua Peng, Lei Zhang, Xiao-Yan Li, Qiao-Miao Zeng, Qian Li, Jian-Hui Zhou
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	esophageal cancer targeted agents chemoradiotherapy meta-analysis systematic review Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/2cfad9d116e243988f8da8f213c4f367
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spelling	oai:doaj.org-article:2cfad9d116e243988f8da8f213c4f3672021-12-01T11:08:45ZEffectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis2234-943X10.3389/fonc.2021.621917https://doaj.org/article/2cfad9d116e243988f8da8f213c4f3672021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.621917/fullhttps://doaj.org/toc/2234-943XBackgroundConcurrent chemoradiotherapy (CRT) is the preferred treatment strategy for inoperable esophageal cancer (EC). However, the effect of CRT needs to be improved.MethodsThis study comprehensively analyzed targeted agents combined with CRT for the treatment of EC by a network meta-analysis. The search was performed in public databases from incipient to 5 August 2021. Randomized controlled trials comparing the effect of targeted agents combined with CRT and CRT alone on EC patients were included.ResultsTen studies were included. For progression-free survival (PFS), nivolumab (67.4%) and erlotinib (64.6%) had advantages based on Cox analysis. Regarding the frequency of PFS, cetuximab (OR: 1.39; 95% CI: 1.01, 1.91; p=0.042) and nivolumab (OR: 1.81; 95% CI: 1.34, 2.44; p<0.01) were significantly superior to the control. For overall survival (OS), nivolumab (71.6%) in Cox analysis and nimotuzumab (69.7%) in frequency analysis were found to have relative advantages. Nimotuzumab combined with CRT was significantly better than the control with regard to endoscopic and the pathologic complete response (epCR; OR: 2.81; 95% CI: 1.28, 6.14; p=0.011) and objective response rate (ORR; 4.71; 95% CI: 1.45, 15.29; p=0.008). The targeted drugs were not associated with significant SEA risk.ConclusionIn conclusion, compared to CRT alone, cetuximab and nivolumab combined with CRT were found to significantly improve the PFS rate only based on the frequency results. However, there was no benefit in terms of OS. For epCR and ORR, nimotuzumab was better than the blank control. Considering the limitations in this study, more well-designed RCTs are needed in the future to validate the results.Peng LiuGuo-Fei WangHua PengLei ZhangXiao-Yan LiQiao-Miao ZengQian LiJian-Hui ZhouJian-Hui ZhouFrontiers Media S.A.articleesophageal cancertargeted agentschemoradiotherapymeta-analysissystematic reviewNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	esophageal cancer targeted agents chemoradiotherapy meta-analysis systematic review Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	esophageal cancer targeted agents chemoradiotherapy meta-analysis systematic review Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Peng Liu Guo-Fei Wang Hua Peng Lei Zhang Xiao-Yan Li Qiao-Miao Zeng Qian Li Jian-Hui Zhou Jian-Hui Zhou Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis
description	BackgroundConcurrent chemoradiotherapy (CRT) is the preferred treatment strategy for inoperable esophageal cancer (EC). However, the effect of CRT needs to be improved.MethodsThis study comprehensively analyzed targeted agents combined with CRT for the treatment of EC by a network meta-analysis. The search was performed in public databases from incipient to 5 August 2021. Randomized controlled trials comparing the effect of targeted agents combined with CRT and CRT alone on EC patients were included.ResultsTen studies were included. For progression-free survival (PFS), nivolumab (67.4%) and erlotinib (64.6%) had advantages based on Cox analysis. Regarding the frequency of PFS, cetuximab (OR: 1.39; 95% CI: 1.01, 1.91; p=0.042) and nivolumab (OR: 1.81; 95% CI: 1.34, 2.44; p<0.01) were significantly superior to the control. For overall survival (OS), nivolumab (71.6%) in Cox analysis and nimotuzumab (69.7%) in frequency analysis were found to have relative advantages. Nimotuzumab combined with CRT was significantly better than the control with regard to endoscopic and the pathologic complete response (epCR; OR: 2.81; 95% CI: 1.28, 6.14; p=0.011) and objective response rate (ORR; 4.71; 95% CI: 1.45, 15.29; p=0.008). The targeted drugs were not associated with significant SEA risk.ConclusionIn conclusion, compared to CRT alone, cetuximab and nivolumab combined with CRT were found to significantly improve the PFS rate only based on the frequency results. However, there was no benefit in terms of OS. For epCR and ORR, nimotuzumab was better than the blank control. Considering the limitations in this study, more well-designed RCTs are needed in the future to validate the results.
format	article
author	Peng Liu Guo-Fei Wang Hua Peng Lei Zhang Xiao-Yan Li Qiao-Miao Zeng Qian Li Jian-Hui Zhou Jian-Hui Zhou
author_facet	Peng Liu Guo-Fei Wang Hua Peng Lei Zhang Xiao-Yan Li Qiao-Miao Zeng Qian Li Jian-Hui Zhou Jian-Hui Zhou
author_sort	Peng Liu
title	Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis
title_short	Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis
title_full	Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis
title_fullStr	Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis
title_full_unstemmed	Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis
title_sort	effectiveness and safety of targeted agents combined with chemoradiotherapy for the treatment of esophageal cancer: a network meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/2cfad9d116e243988f8da8f213c4f367
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Effectiveness and Safety of Targeted Agents Combined With Chemoradiotherapy for the Treatment of Esophageal Cancer: A Network Meta-Analysis

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