The Prognostic Effect of Dexamethasone on Patients With Glioblastoma: A Systematic Review and Meta-Analysis

Background: Dexamethasone (DEX) is widely adopted to reduce tumor-associated edema in glioblastoma (GBM) patients despite its side effects. However, the benefits of using DEX in GBM patients remains elusive.Methods: In this study, we performed a comprehensive meta-analysis to address this concern. We searched the relevant studies from PubMed, Web of Science, and EMBASE databases, and then applied random or fixed-effects models to generate estimated summary hazard radios (HRs) and the 95% confidence intervals (CIs). Moreover, subgroup and sensitivity analysis were conducted and publication bias were further evaluated.Results: Ten articles with a total of 2,230 GBM patients were eligible according to the inclusion criteria. In the assessment of overall survival (OS), meta-analysis data revealed that DEX was significantly associated with the poor prognosis of GBM patients (HR=1.44, 95% CI=1.32−1.57). In the progression-free survival (PFS), the pooled results indicated that the use of DEX can increase 48% death risk for GBM patients (HR=1.48, 95% CI=1.11−1.98). Subgroup analyses revealed that DEX was associated with poorer outcome of GBM in subgroup of newly diagnosed patients and GBM patients treated with ≥ 2mg/day. Sensitivity analyses showed that no study changed the pooled results materially for both OS and PFS analyses. The funnel plot had no obvious asymmetry.Conclusion: Our findings partly confirmed that use of DEX was associated with poor treatment outcome in GBM patients. To reach a definitive conclusion, large samples from multi-centers are urgent to address this concern.

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Predictive value of primary tumor location (TL) in patients (pts) with pan-RAS wild-type (wt) metastatic colorectal cancer (mCRC) receiving chemotherapy (CTX) ± cetuximab or panitumumab (C/P): An updated meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.830 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 830-830 ◽

Cited By ~ 1

Author(s):

Zi-Xian Wang ◽

Ming-ming He ◽

Ying-Nan Wang ◽

Feng Wang ◽

Rui-hua Xu

Keyword(s):

Random Effects ◽

Fixed Effects ◽

Meta Analysis ◽

Objective Response ◽

Progression Free Survival ◽

Tumor Location ◽

Significant Heterogeneity ◽

Free Survival ◽

Randomized Controlled ◽

Analytic Models

830 Background: Previous evidence suggests that TL may be predictive of the efficacy of C/P versus bevacizumab. This meta-analysis was aimed to evaluate the efficacy of CTX plus C/P versus CTX only as a first-line (1L) or second-line (2L) treatment for RAS wt right- and left-sided mCRC (R- and L-mCRC) in randomized controlled trials (RCTs). Methods: A systematic literature review was performed of PubMed and oncology congress websites (2000–present). RCTs studying the additional efficacy of C/P to CTX in RAS wt R- and L-mCRC were included. Assessed outcomes included progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Random-effects meta-analytic models were used in the presence of significant heterogeneity ( I2> 50%). Otherwise, fixed-effects models were performed. Random-effects meta-regression models were used to evaluate the interaction between TL and the efficacy of C/P. Results: A total of three 1L RCTs (CRYSTAL, PRIME, and TAILOR) and one 2L RCT (20050181) were included (325 pts with R-mCRC and 1214 with L-mCRC). Pooled estimates of the efficacy of C/P are summarized in the table. In both R- and L-mCRC pts, the addition of C/P to CTX significantly improved PFS and ORR. A significant OS benefit from C/P was observed in L-mCRC but not R-mCRC pts. No significant interaction was detected between TL and the efficacy of C/P on PFS, OS, and ORR ( P= 0.69, 0.09, and 0.22, respectively). Conclusions: Adding C/P to CTX clearly benefits RAS wt L-mCRC pts in terms of PFS, OS, and ORR. Considering the improvements in PFS and ORR versus CTX only, anti-EGFR agents remain an option for pts with RAS wt R-mCRC. [Table: see text]

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Meta-analysis of prognostic biomarkers for pancreatic neuroendocrine tumors (PNETs).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e15688 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e15688-e15688

Author(s):

Mojun Zhu ◽

Thorvardur Ragnar Halfdanarson ◽

Bonnie Elyssa Gould Rothberg

Keyword(s):

Proportional Hazards ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Enzyme Linked Immunosorbent Assay ◽

Source Population ◽

Inclusion Criteria ◽

Primary Tumors ◽

Free Survival ◽

Specific Pcr

e15688 Background: PNETs are marked by histological heterogeneity and variable clinical outcomes. Other than Ki67 index, reliable circulating or tissue biomarkers for prognosis do not exist. Methods: PubMed was searched through 01/31/2017. Inclusion criteria were: 1) prospective/retrospective cohort with defined source population, boundary dates, and justifications for exclusions; 2) assay of primary tumors; 3) clear descriptions of methods including techniques and controls; 4) use of multivariate proportional hazards modeling adjusted for prognostic factors including but not limited to stage or grade; and 5) reporting adjusted hazard ratios (HR) with 95 % confidence intervals and P values. Studies with < 50 % PNETs were excluded. PNET-specific data was summarized in the table. Results: A total of 2958 manuscripts were identified and 462 manuscripts were reviewed. Only 23 multivariate studies met all inclusion criteria. These altogether analyzed 24 unique targets and 14 were associated with survival. Conclusions: This meta-analysis identified 14 markers associated with survival of PNET patients. Future studies should adhere to the REMARK criteria and incorporate the 2017 WHO grading system for multivariate analysis. 1. I-immunohistochemistry, F-fluorescence in situ hybridization, E-enzyme linked immunosorbent assay, M- methylation specific PCR, P-polymerase chain reaction; 2. O-overall survival, F-disease free survival, S-disease specific survival, P- progression free survival.[Table: see text]

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Efficacy of Regorafenib in Hepatocellular Carcinoma Patients: A Systematic Review and Meta-Analysis

Cancers ◽

10.3390/cancers12010036 ◽

2019 ◽

Vol 12 (1) ◽

pp. 36 ◽

Cited By ~ 5

Author(s):

Antonio Facciorusso ◽

Mohamed A. Abd El Aziz ◽

Rodolfo Sacco

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Adverse Events ◽

Therapeutic Option ◽

Controlled Trial ◽

Meta Analysis ◽

Objective Response ◽

Progression Free Survival ◽

Sensitivity Analyses ◽

Free Survival

Regorafenib showed promising results as a second-line agent after sorafenib failure in hepatocellular carcinoma patients. The aim of this meta-analysis was to evaluate the efficacy and safety of regorafenib in hepatocarcinoma patients. A computerized bibliographic search was performed on the main databases. The primary outcome was overall survival. Secondary outcomes were progression-free survival, tumor response, and the adverse events rate. Outcomes were pooled through a random-effects model and summary estimates were expressed in terms of median and 95% confidence interval or rates, as appropriate. One randomized-controlled trial and seven non-randomized studies with 809 patients were included. The great majority of recruited patients were in Child-Pugh A and ECOG 0 stage. Median overall survival was 11.08 months (9.46–12.71) and sensitivity analyses confirmed this finding, with a median survival ranging from 10.2 to 13.8 months. Duration of regorafenib therapy was 3.58 months, whereas median progression-free survival was 3.24 months (2.68–3.86). The pooled objective response rate was 10.1% (7.8–12.5%) while the disease control rate was 65.5% (61.3–69.7%) with no evidence of heterogeneity (I2 = 0%; Diarrhea, fatigue, and hand-foot skin reaction were the most frequent adverse events. The current meta-analysis shows that regorafenib represents a valuable and relatively safe therapeutic option in intermediate/advanced hepatocellular carcinomapatients who progress on sorafenib.

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Efficacy of Nucleot(s)ide Analogs Therapy in Patients with Unresectable HBV-Related Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2017/7075935 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Lingling He ◽

Xiaoli Liu ◽

Yalin Zhao ◽

Shuan Zhang ◽

Yuyong Jiang ◽

...

Keyword(s):

Overall Survival ◽

Best Practice ◽

Therapy Group ◽

Meta Analysis ◽

Progression Free Survival ◽

Treated Group ◽

Sensitivity Analyses ◽

Secondary Outcome ◽

Control Group ◽

Free Survival

Aim. To determine whether nucleot(s)ide analogs therapy has survival benefit for patients with HBV-related HCC after unresectable treatment.Method. A systematic search was conducted through seven electronic databases including PubMed, OVID, EMBASE, Cochrane Databases, Elsevier, Wiley Online Library, and BMJ Best Practice. All studies comparing NA combined with unresectable treatment versus unresectable treatment alone were considered for inclusion. The primary outcome was the overall survival (OS) after unresectable treatment for patients with HBV-related HCC. The secondary outcome was the progression-free survival (PFS). Results were expressed as hazard ratio (HR) for survival with 95% confidence intervals.Results. We included six studies with 994 patients: 409 patients in nucleot(s)ide analogs therapy group and 585 patients without antiviral therapy in control group. There were significant improvements for the overall survival (HR = 0.57; 95% CI = 0.47–0.70;p< 0.001) and progression-free survival (HR = 0.84; 95% CI = 0.71–0.99;p= 0.034) in the NA-treated group compared with the control group. Funnel plot showed that there was no significant publication bias in these studies. When it comes to antiviral drugs and operation method, it also showed benefit in NA-treated group. At the same time, overall mortality as well as mortality secondary to liver failure in NA-treated group was obviously lesser. Sensitivity analyses confirmed the robustness of the results.Conclusions. Nucleot(s)ide analogs therapy after unresectable treatment has potential beneficial effects in terms of overall survival and progression-free survival. NA therapy should be considered in clinical practice.

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The Most Efficacious Induction Chemotherapy Regimen for Locoregionally Advanced Nasopharyngeal Carcinoma: A Network Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.626145 ◽

2021 ◽

Vol 11 ◽

Author(s):

Horace Cheuk-Wai Choi ◽

Sik-Kwan Chan ◽

Ka-On Lam ◽

Sum-Yin Chan ◽

Sze-Chun Chau ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Induction Chemotherapy ◽

Fixed Effects ◽

Concurrent Chemoradiotherapy ◽

Meta Analysis ◽

Intensity Modulated Radiation Therapy ◽

Progression Free Survival ◽

Free Survival ◽

Hazard Ratios ◽

Analysis Models

BackgroundInduction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) for non-metastatic locoregionally advanced nasopharyngeal carcinoma (NPC) has gained considerable attention. However, the most efficacious IC regimens remain investigational. We aimed to compare the survival benefits of all available IC regimens followed by CCRT in this network meta-analysis.MethodsAll randomized-controlled trials of CCRT with or without IC in non-metastatic locoregionally advanced NPC were included, with an overall nine trials of 2,705 patients counted in the analysis. CCRT alone was the reference category. Eight IC regimens followed by CCRT were analyzed: docetaxel + cisplatin (DC), gemcitabine + carboplatin + paclitaxel (GCP), gemcitabine + cisplatin (GP), mitomycin + epirubicin + cisplatin + fluorouracil + leucovorin (MEPFL), cisplatin + epirubicin + paclitaxel (PET), cisplatin + fluorouracil (PF), cisplatin + capecitabine (PX) and cisplatin + fluorouracil (PF), cisplatin + capecitabine (PX). Fixed-effects frequentist network meta-analysis models was applied and P-score was used to rank the treatments.ResultsDC, GP, and PX were the top three IC regimens with the highest probability of benefit on overall survival (OS). Their corresponding hazard ratios (HRs) (95% CIs) compared with CCRT alone were of 0.24 (0.08–0.73), 0.43 (0.24–0.77), and 0.54 (0.27–1.09) and the respective P-scores were 94%, 82%, and 68%. The first three IC regimens showing significantly improved progression-free survival (PFS) were PX, followed by GP and DC with respective HRs of 0.46 (0.24–0.88), 0.51 (0.34–0.77), and 0.49 (0.20–1.20), and P-scores of 82%, 78%, and 74%. Among the studies in the intensity-modulated radiation therapy (IMRT) era, GP and PX were the best performed IC regimens, whilst DC performed the best among non-IMRT studies. Doublet and gemcitabine-based IC regimens had better survival benefits compared to triplet and taxane-based IC regimens, respectively.ConclusionsGiven its consistent superiority in both OS and PFS, DC, GP, and PX ranked among the three most efficacious IC regimens in both the overall and subgroup analysis of IMRT or non-IMRT studies. Exploratory analyses suggested that doublet and gemcitabine-based IC regimens showed better survival performance.

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FOLFOXIRI versus FOLFOX or FOLFIRI with targeted therapy in patients with mutant BRAF metastatic colorectal cancer: A systematic review and meta-analysis

Medical Council ◽

10.21518/2079-701x-2020-20-125-132 ◽

2020 ◽

pp. 125-132

Author(s):

M. Yu. Fedyanin ◽

E. M. Polyanskaya ◽

H. H.-M. Elsnukaeva ◽

A. A. Tryakin ◽

I. A. Pokataev ◽

...

Keyword(s):

Colorectal Cancer ◽

Targeted Therapy ◽

Metastatic Colorectal Cancer ◽

Subgroup Analysis ◽

Fixed Effects ◽

Meta Analysis ◽

Objective Response ◽

Progression Free Survival ◽

Systemic Review ◽

Free Survival

Introduction. Based on the subgroup analysis of the TRIBE study FOLFOXIRI with bevacizumab is the recommended option for patients (pts) with mBRAF metastatic colorectal cancer (mCRC) in the 1st line. However, subgroup analysis of other studies showed conflicting results. Therefore, we performed systemic review and meta-analysis to compare efficacy FOLFOXIRI and doublets with targeted therapy in pts with mBRAF mCRC in terms of progression free survival (PFS), objective response rate (ORR) and overall survival (OS).Methods. We performed a search of all prospective randomizes studies in PubMed, ASCO and ESMO congresses for all years before May, 2020, compared FOLFOXIRI plus bevacizumab or anti-EGFR antibodies and FOLFOX or FOLFIRI with targeted agents at the 1st line with information of the BRAF status. Primary outcome was hazard ratio (HR) for PFS and 95% confidence interval (CI); secondary – HR for OS and odds ratio (OD) for ORR. Fixed effects were used for analysis. Meta-analysis was conducted by Review Manager Ver. 5.3.Results. We identified 6 trials (CHARTA, STEAM, TRIBE, TRIBE2, VISNU, METHEP2), which included 158 pts with mBRAF (FOLFOXIRI – 82 (52%) and doublets – 76 (48%). According to results of the meta-analysis there was a tendency for higher ORR in pts with FOLFOXIRI (OR 2.07, 95% CI 0.61–7.06; p = 0.24; I2 = 27%, p for heterogeneity 0.26; 3 trials). However we didn’t find any significant improvement in PFS (HR 0.89, 95% CI 0.64–1.23; p = 0.48; I2 = 0%, p for heterogeneity 0.63; 5 trials) or OS (HR 0.9, 95% CI 0.37–1.19; p = 0.048; I2 = 71%, p for heterogeneity 0.06; 2 trials) in the group of triplet.Conclusions. FOLFOXIRI with targeted therapy did not show significant improvement in the PFS and OS in pts with mBRAF compared with FOLFOX or FOLFIRI with targeted antibodies. A prospective randomized trial is needed to determine the optimal chemotherapy regimen at the 1st line for pts with mBRAF mCRC.

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The Efficacy and Safety of PD-1/PD-L1 Inhibitors in Combination with Conventional Therapies for Advanced Solid Tumors: A Meta-Analysis

BioMed Research International ◽

10.1155/2020/5059079 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Run-Cong Nie ◽

Chong-Bang Zhao ◽

Xiao-Wei Xia ◽

Ying-Shan Luo ◽

Ting Wu ◽

...

Keyword(s):

Solid Tumors ◽

Meta Analysis ◽

Progression Free Survival ◽

Sensitivity Analyses ◽

Cochrane Library ◽

High Grade ◽

Advanced Solid Tumors ◽

Free Survival ◽

Hazard Ratios ◽

Programmed Cell Death 1

Objectives. To evaluate the efficacy of immuno-oncology combinational therapy (IOCT) versus monotherapy with programmed cell death 1 (PD-1) or PD-ligand 1 (PD-L1) inhibitors or conventional therapies, i.e., non-IOCT, in patients with advanced solid tumors. Methods. We systematically searched the PubMed, Embase, and Cochrane Library databases from January 2015 to October 2018 for eligible studies. We included randomized trials of IOCT with available hazard ratios (HR) for death. The random effects model was used to calculate pooled HR for death; heterogeneity was assessed using I2 statistics. The main outcome measure was overall survival (OS). Results. After screening 483 relevant articles, we identified twelve trials comprising 5388 patients for quantitative analysis. IOCT-treated patients had significantly higher tumor response rate (relative risk (RR): 2.51, 95% confidence interval (CI): 1.82-3.47), prolonged progression-free survival (HR 0.62, 95% CI: 0.53-0.74), and OS (HR 0.69, 95% CI: 0.61-0.78), compared with non-IOCT–treated patients. Sensitivity analyses also demonstrated the OS advantage of IOCT across different combination modalities, intervention agents, malignancy types, and PD-L1 expression (all P<0.05). Notably, there were higher odds of high-grade (grade≥3) adverse events with IOCT (RR: 1.81, 95% CI: 1.13-2.90), but the risk of treatment-related death (RR: 1.16, 95% CI: 0.84–1.60) was not increased compared with non-IOCT. Conclusions. IOCT is a preferable treatment option over PD-1/PD-L1 inhibitor monotherapy and conventional therapy for patients with advanced solid tumors. However, we should note the increased incidence rate of high-grade AEs in IOCT.

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Efficacy Of Bortezomib-Based Regimens With Or Without An Immunomodulatory Agent In Older Adults With Multiple Myeloma: A Systematic Review and Meta-Analysis

Blood ◽

10.1182/blood.v122.21.5580.5580 ◽

2013 ◽

Vol 122 (21) ◽

pp. 5580-5580

Author(s):

Jordan Atkins ◽

Susan A Fowler ◽

Methodius Tuuli ◽

Aimee S James ◽

Tanya M Wildes

Keyword(s):

Systematic Review ◽

Multiple Myeloma ◽

Overall Survival ◽

Partial Response ◽

Meta Analysis ◽

Progression Free Survival ◽

Complete Response ◽

Inclusion Criteria ◽

Free Survival ◽

Good Partial Response

Abstract Introduction Multiple myeloma (MM) is an incurable disease within older adults, caused by the malignant proliferation of plasma cells and destruction of skeletal structure, with subsequent end-organ dysfunction. In the elderly and transplant ineligible population, chemotherapeutic regimens that include novel and conventional drugs are currently being employed to attain optimal response and survival outcomes. We performed a systematic review and meta-analysis to investigate the efficacy of the proteasome inhibitor bortezomib, in combination with an immunomodulatory drug (IMiD) versus bortezomib-containing regimens alone in improving overall survival, progression-free survival, and response in patients aged 65 and older ineligible for stem cell transplant. Methods We searched Pubmed/Medline, Embase, Scopus, CENTRAL, DARE, and clinicaltrials.gov databases for randomized controlled trials (RCTs) published from January 1946 until March 2013 using search terms such as: “bortezomib” “thalidomide/analogs and derivatives” and “lenalidomide.” Primary outcomes such as overall survival “OS” and progression-free survival “PFS” were harvested from standard indexes and on-topic articles. We abstracted data from relevant studies for analysis. Heterogeneity was assessed using Cochrane's Q and Higgin's I2 with p<0.1 considered significant. Pooled risk ratios (RR) and hazard ratios (HR) were estimated using DerSimonain and Laird random effect models. Results We identified 762 studies, 201 of which were duplicates that were excluded. Of these studies, 561 met initial inclusion criteria. After screening and systematic review, we found a majority of the articles originated from sub-analyses or reviews of 2 major studies which fully met inclusion criteria: 1) bortezomib-melphalan-prednisone-thalidomide (VMPT) versus bortezomib-melphalan-prednisone (VMP) [Palumbo JCO 2010] and 2) bortezomib-thalidomide-prednisone (VTP) versus VMP [Mateos Lancet Onc 2010). Of the two studies included, 384 patients received thalidomide and bortezomib-containing regimens (VMPT or VTP), and 387 patients received VMP. Thalidomide-containing combinations were associated with improvement in complete response (pooled RR 1.55 [95% Confidence intervals 1.23-1.95]) and very good partial response (pooled RR 1.19 [95% Confidence intervals 1.04-1.38]). There was no evidence of significant heterogeneity associated with either of these outcomes across the studies (I2=0; p=0.559 and I2=0; p=0.600). There were no significant differences in partial response (pooled RR 1.08; 95% CI 0.98-1.19), overall survival (pooled HR 1.04; 95% CI 0.65-1.44), or progression-free survival (pooled HR 0.91; 95% CI 0.29-1.42). There were also no significant differences in toxic side effects (Table). Conclusion Based on the limited data included in this meta-analysis, we found that the addition of thalidomide to a bortezomib-based regimen was associated with improved complete response and very good partial response, but no improvement in overall or progression-free survival. Larger studies of thalidomide and other immunomodulatory agents are required to further clarify the role of adding IMiDs to bortezomib-based regimens in the treatment of MM. Disclosures: No relevant conflicts of interest to declare.

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Is antiangiogenic therapy necessary for patients with metastatic colorectal cancer (mCRC) and mutation in the BRAF gene? Results of the systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.88 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 88-88

Author(s):

Mikhail Fedyanin ◽

Elizaveta Polyanskaya ◽

Kheda Elsnukaeva ◽

Alexey Tryakin ◽

Ilya Pokataev ◽

...

Keyword(s):

Fixed Effects ◽

Meta Analysis ◽

Antiangiogenic Therapy ◽

Progression Free Survival ◽

Phase Iii ◽

Systemic Review ◽

Free Survival ◽

Angiogenic Therapy ◽

Antiangiogenic Drugs ◽

Optimal Regimen

88 Background: There are no direct prospective randomized studies supporting the need for antiangiogenic drugs in the treatment of patients with the m BRAF mCRC. However, subgroup analysis of different studies showed conflicting results. Therefore, we performed systemic review and meta-analysis to compare efficacy anti-angiogenic targeted therapy with chemotherapy and chemotherapy alone in patients with m BRAF mCRC in terms of progression free survival (PFS), and overall survival (OS). Methods: We performed a search of all prospective randomized phase III studies in PubMed, ASCO and ESMO congresses for all years before September, 2020, compared chemotherapy (CT) plus bevacizumab or aflibercept or ramucirumab and CT alone at the first-line or second-lines with information of the BRAF status. Primary outcome was hazard ratio (HR) for PFS and 95% confidence interval (CI); secondary–HR for OS and 95%CI. Fixed effects were used for analysis. Meta-analysis was conducted by "Review Manager" Ver. 5.3. Results: We identified 4 trials (AVF2107g, AGITG MAX, VELOUR and RAISE), which included 120 patients with mBRAF (anti-angiogenic plus CT–65 (54%) and CT alone–55 (46%). According to results of the meta-analysis there was a tendency for significant improvement in PFS (HR 0.64, 95% CI 0.4-1.02; p = 0.06; I2 = 0%, p for heterogeneity 0.7; 53trials) and significant improvement in OS (HR 0.51, 95% CI 0.32-0.82; p = 0.005; I2 = 0%, p for heterogeneity 0.52; 4 trials) in group of ani-angiogenic therapy. Conclusions: Addition of anti-angiogenic therapy to chemotherapy showed improvement in the PFS and OS in pts with m BRAF compared with chemotherapy alone. A prospective randomized trial is needed to determine the optimal regimen of systemic therapy for pts with m BRAF mCRC.

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The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2020/4565379 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Rongqiang Liu ◽

Shiyang Zheng ◽

Qing Yuan ◽

Peiwen Zhu ◽

Biao Li ◽

...

Keyword(s):

Prognostic Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

Regression Analyses ◽

Free Survival ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Meta Regression

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

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