Clinical outcomes of active specific immunotherapy in advanced colorectal cancer and suspected minimal residual colorectal cancer: a meta-analysis and system review

Journal of Translational Medicine

Research

Jun Huang¹  Meijin Huang¹  Jianping Wang²  Benqiang Rao²  Lei Wang²  Xiaoyan Gao³  Huanliang Liu⁴  Minyan Han⁵ 

[1] Colorectal Surgery Department, The Sixth Affiliated Hospital, Sun Yat-sen University, 510655, Guangdong, PR, China;Colorectal Surgery Department, The Sixth Affiliated Hospital, Sun Yat-sen University, 510655, Guangdong, PR, China;Institute of Gastroenterology, Sun Yat-sen University, 510655, Guangzhou, Guangdong, PR, China;Department of Pediatrics, The Sixth Affiliated Hospital, Sun Yat-sen University, 510655, Guangdong, PR, China;Institute of Gastroenterology, Sun Yat-sen University, 510655, Guangzhou, Guangdong, PR, China;Medical Department, The Sixth Affiliated Hospital, Sun Yat-sen University, 510655, Guangdong, PR, China;

关键词: Overall Survival;    Weighted Mean Difference;    Advanced Colorectal Cancer;    Minor Response;    Clinical Benefit Rate;   

DOI  :  10.1186/1479-5876-9-17

 received in 2010-04-30, accepted in 2011-01-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundTo evaluate the objective clinical outcomes of active specific immunotherapy (ASI) in advanced colorectal cancer (advanced CRC) and suspected minimal residual colorectal cancer (suspected minimal residual CRC).MethodsA search was conducted on Medline and Pub Med from January 1998 to January 2010 for original studies on ASI in colorectal cancer (CRC). All articles included in this study were assessed with the application of predetermined selection criteria and were divided into two groups: ASI in advanced CRC and ASI in suspected minimal residual CRC. For ASI in suspected minimal residual CRC, a meta-analysis was executed with results regarding the overall survival (OS) and disease-free survival (DFS). Regarding ASI in advanced colorectal cancer, a system review was performed with clinical outcomes.Results1375 colorectal carcinoma patients with minimal residual disease have been enrolled in Meta-analysis. A significantly improved OS and DFS was noted for suspected minimal residual CRC patients utilizing ASI (For OS: HR = 0.76, P = 0.007; For DFS: HR = 0.76, P = 0.03). For ASI in stage II suspected minimal residual CRC, OS approached significance when compared with control (HR = 0.71, P = 0.09); however, the difference in DFS of ASI for the stage II suspected minimal residual CRC reached statistical significance (HR = 0.66, P = 0.02). For ASI in stage III suspected minimal residual CRC compared with control, The difference in both OS and DFS achieved statistical significance (For OS: HR = 0.76, P = 0.02; For DFS: HR = 0.81, P = 0.03). 656 advanced colorectal patients have been evaluated on ASI in advanced CRC. Eleven for CRs and PRs was reported, corresponding to an overall response rate of 1.68%. No serious adverse events have been observed in 2031 patients.ConclusionsIt is unlikely that ASI will provide a standard complementary therapeutic approach for advanced CRC in the near future. However, the clinical responses to ASI in patients with suspected minimal residual CRC have been encouraging, and it has become clear that immunotherapy works best in situations of patients with suspected minimal residual CRC.

【 授权许可】

Unknown   
© Rao et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.