Cochrane · systematic review · CD006875
Second‐line systemic therapy for metastatic colorectal cancer
Mocellin, S, Baretta, Z, Roqué i Figuls, M, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
ColorectalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
32
current version
GRADE rated
30
No studies
2
Included studies
NR
No studies 2 · 6.3%Ungraded 0 · 0%Very low 1 · 3.1%Low 4 · 12.5%Moderate 14 · 43.8%High 11 · 34.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Modern chemotherapy regimens compared with 5‐flourouracil
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Modern chemotherapy regimens vs 5‐flourouracil | HR 0.69 [0.51, 0.94] | 1 study · 167 participants | Moderate |
Progression‐free survival Modern chemotherapy regimens vs 5‐flourouracil | HR 0.59 [0.49, 0.73] | 2 studies · 470 participants | High |
Overall tumour response Modern chemotherapy regimens vs 5‐flourouracil | RR 2.96 [1.66, 5.27] | 3 studies · 866 participants | High |
Severe adverse effects Modern chemotherapy regimens vs 5‐flourouracil | RR 1.39 [1.22, 1.58] | 3 studies · 843 participants | Moderate |
Chemotherapy + bevacizumab compared with chemotherapy
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Chemotherapy + bevacizumab vs chemotherapy | HR 0.79 [0.7, 0.88] | 4 studies · 1723 participants | High |
Progression‐free survival Chemotherapy + bevacizumab vs chemotherapy | HR 0.67 [0.6, 0.75] | 4 studies · 1723 participants | High |
Overall tumour response Chemotherapy + bevacizumab vs chemotherapy | RR 1.72 [1.23, 2.43] | 4 studies · 1723 participants | High |
Severe adverse effects Chemotherapy + bevacizumab vs chemotherapy | RR 1.07 [0.93, 1.25] | 4 studies · 1708 participants | Low |
Irinotecan‐based regimens compared with irinotecan
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression‐free survival Irinotecan‐based regimens vs irinotecan | HR 0.68 [0.6, 0.76] | 6 studies · 2615 participants | Moderate |
Overall survival Irinotecan‐based regimens vs irinotecan | HR 0.91 [0.79, 1.04] | 6 studies · 2615 participants | Low |
Overall tumour response Irinotecan‐based regimens vs irinotecan | RR 2.87 [2.1, 3.93] | 6 studies · 2577 participants | High |
Severe adverse effects Irinotecan‐based regimens vs irinotecan | RR 1.18 [0.96, 1.45] | 6 studies · 2510 participants | Moderate |
Irinotecan + oxaliplatin compared with irinotecan
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Irinotecan + oxaliplatin vs irinotecan | HR 0.78 [0.67, 0.9] | 1 study · 627 participants | Moderate |
Progression‐free survival Irinotecan + oxaliplatin vs irinotecan | HR 0.6 [0.55, 0.66] | 1 study · 627 participants | Moderate |
Overall tumour response Irinotecan + oxaliplatin vs irinotecan | RR 2.98 [1.91, 4.64] | 1 study · 627 participants | Moderate |
Severe adverse effects Irinotecan + oxaliplatin vs irinotecan | RR 1.22 [1.09, 1.37] | 1 study · 627 participants | Moderate |
Chemotherapy compared with best supportive care
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Chemotherapy vs best supportive care | HR 0.58 [0.43, 0.8] | 1 study · 279 participants | Moderate |
Progression‐free survival Chemotherapy vs best supportive care | no estimate extracted | NR | No studies |
Overall tumour response Chemotherapy vs best supportive care | no estimate extracted | NR | No studies |
Severe adverse effects Chemotherapy vs best supportive care | RR 1.19 [1.01, 1.4] | 1 study · 279 participants | Moderate |
FOLFIRI + targeted therapy compared with FOLFIRI
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival FOLFIRI + targeted therapy vs FOLFIRI | HR 0.84 [0.77, 0.91] | 6 studies · 3335 participants | High |
Progression‐free survival FOLFIRI + targeted therapy vs FOLFIRI | HR 0.78 [0.71, 0.87] | 6 studies · 3335 participants | High |
Overall tumour response FOLFIRI + targeted therapy vs FOLFIRI | RR 2.07 [1.31, 3.28] | 6 studies · 3192 participants | Moderate |
Severe adverse effects FOLFIRI + targeted therapy vs FOLFIRI | RR 1.3 [1.17, 1.45] | 6 studies · 3341 participants | Moderate |
FOLFOX + targeted therapy compared with FOLFOX
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival FOLFOX + targeted therapy vs FOLFOX | HR 0.92 [0.82, 1.04] | 2 studies · 1432 participants | Very low |
Progression‐free survival FOLFOX + targeted therapy vs FOLFOX | HR 0.76 [0.66, 0.86] | 2 studies · 1432 participants | Low |
Overall tumour response FOLFOX + targeted therapy vs FOLFOX | RR 2.64 [1.71, 4.06] | 1 study · 578 participants | Moderate |
Severe adverse effects FOLFOX + targeted therapy vs FOLFOX | RR 1.2 [1.13, 1.28] | 2 studies · 1414 participants | High |
Irinotecan + targeted therapy compared with irinotecan
Population: people with metastatic CRC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Irinotecan + targeted therapy vs irinotecan | HR 0.99 [0.88, 1.1] | 2 studies · 1758 participants | Low |
Progression‐free survival Irinotecan + targeted therapy vs irinotecan | HR 0.71 [0.64, 0.79] | 2 studies · 1758 participants | Moderate |
Overall tumour response Irinotecan + targeted therapy vs irinotecan | RR 3.38 [2.53, 4.52] | 2 studies · 1758 participants | High |
Severe adverse effects Irinotecan + targeted therapy vs irinotecan | RR 1.44 [1.31, 1.59] | 2 studies · 1704 participants | High |