What do systematic reviews say?

Delayed chemotherapy vs immediate chemotherapy

Delayed chemotherapy showed no clear difference in overall survival compared with immediate chemotherapy (low certainty).

• Survival differences with immediate versus delayed chemotherapy for asymptomatic incurable metastatic colorectal cancer 2018 · Cochrane Headline outcomes only
  HR 1.17 [0.93, 1.46]
  3 studies · 351 participants
  Low

Delayed chemotherapy vs immediate chemotherapy

• Survival differences with immediate versus delayed chemotherapy for asymptomatic incurable metastatic colorectal cancer 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 351 participants
  Low

Combination chemotherapy vs single‐agent chemotherapy

It is very uncertain whether combination chemotherapy changes overall survival (3 years) compared with single‐agent chemotherapy (very low certainty).

• Combination chemotherapy versus single‐agent chemotherapy during preoperative chemoradiation for resectable rectal… 2015 · Cochrane Headline outcomes only
  HR 0.94 [0.59, 1.48]
  1 study · 598 participants
  Very low

Chemotherapy vs best supportive care

Chemotherapy probably leads to lower overall survival compared with best supportive care (moderate certainty).

• Second‐line systemic therapy for metastatic colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.58 [0.43, 0.8]
  1 study · 279 participants
  Moderate

Combination chemotherapy vs single‐agent chemotherapy

It is very uncertain whether combination chemotherapy changes disease‐free survival (3 years) compared with single‐agent chemotherapy (very low certainty).

• Combination chemotherapy versus single‐agent chemotherapy during preoperative chemoradiation for resectable rectal… 2015 · Cochrane Headline outcomes only
  HR 0.88 [0.65, 1.18]
  1 study · 598 participants
  Very low

Chemotherapy vs best supportive care

The review found no eligible studies for this question.

• Second‐line systemic therapy for metastatic colorectal cancer 2017 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Bevacizumab plus chemotherapy vs chemotherapy alone

Chemotherapy + bevacizumab leads to lower overall survival compared with chemotherapy (high certainty).

• Second‐line systemic therapy for metastatic colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.79 [0.7, 0.88]
  4 studies · 1723 participants
  High

Bevacizumab plus chemotherapy vs chemotherapy alone

Chemotherapy + bevacizumab leads to lower progression‐free survival compared with chemotherapy (high certainty).

• Second‐line systemic therapy for metastatic colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.67 [0.6, 0.75]
  4 studies · 1723 participants
  High

Modern chemotherapy regimens vs 5‐flourouracil

Modern chemotherapy regimens probably leads to lower overall survival compared with 5‐flourouracil (moderate certainty).

• Second‐line systemic therapy for metastatic colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.69 [0.51, 0.94]
  1 study · 167 participants
  Moderate

Modern chemotherapy regimens vs 5‐flourouracil

Modern chemotherapy regimens leads to lower progression‐free survival compared with 5‐flourouracil (high certainty).

• Second‐line systemic therapy for metastatic colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.59 [0.49, 0.73]
  2 studies · 470 participants
  High

Adjunctive Coriolus versicolor vs no adjunctive treatment

Adjunctive Coriolus versicolor may leads to higher survival ‐ compared with no adjunctive treatment (low certainty).

• Coriolus (Trametes) versicolor mushroom to reduce adverse effects from chemotherapy or radiotherapy in people with… 2022 · Cochrane Headline outcomes only
  RR 1.08 [1.01, 1.15]
  3 studies · 1094 participants
  Low

Oral vs intravenous fluoropyrimidines

Oral showed no clear difference in overall survival compared with intravenous fluoropyrimidines (high certainty).

• Oral versus intravenous fluoropyrimidines for colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.92 [0.84, 1]
  7 studies · 8902 participants
  High

Oral vs intravenous fluoropyrimidines

Oral showed no clear difference in overall survival compared with intravenous fluoropyrimidines (high certainty).

• Oral versus intravenous fluoropyrimidines for colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 1.02 [0.99, 1.05]
  29 studies · 12079 participants
  High

Oral vs intravenous fluoropyrimidines

Oral showed no clear difference in disease‐free survival compared with intravenous fluoropyrimidines (moderate certainty).

• Oral versus intravenous fluoropyrimidines for colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 0.93 [0.87, 1]
  7 studies · 8903 participants
  Moderate

Oral vs intravenous fluoropyrimidines

Oral probably leads to higher progression‐free survival compared with intravenous fluoropyrimidines (moderate certainty).

• Oral versus intravenous fluoropyrimidines for colorectal cancer 2017 · Cochrane Headline outcomes only
  HR 1.06 [1.02, 1.11]
  23 studies · 9927 participants
  Moderate

IRI with fluoropyrimidines vs single agent IRI

IRI with fluoropyrimidines showed no clear difference in overall survival (Death) compared with single agent IRI (low certainty).

• Irinotecan chemotherapy combined with fluoropyrimidines versus irinotecan alone for overall survival and… 2016 · Cochrane Headline outcomes only
  HR 0.91 [0.81, 1.02]
  5 studies · 1728 participants
  Low

IRI with fluoropyrimidines vs single agent IRI

IRI with fluoropyrimidines probably leads to lower progression‐free survival (Disease progression) compared with single agent IRI (moderate certainty).

• Irinotecan chemotherapy combined with fluoropyrimidines versus irinotecan alone for overall survival and… 2016 · Cochrane Headline outcomes only
  HR 0.68 [0.53, 0.83]
  3 studies · 600 participants
  Moderate