Anti-angiogenic therapy for metastatic colorectal cancer

 

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

To evaluate, in terms of efficacy and toxicity, the effect of anti-angiogenic therapy in addition to chemotherapy in patients with CRC.

Comparisons will be as follows:

• 1) First-line intravenous chemotherapy in combination with angiogenesis inhibitor, to the same chemotherapy without angiogenesis inhibitor
  
• 2) Second-line intravenous chemotherapy in combination with angiogenesis inhibitor, to the same chemotherapy without angiogenesis inhibitor
  
• 3) Adjuvant systemic chemotherapy in combination with angiogenesis inhibitor, to the same chemotherapy without angiogenesis inhibitor
  

In a first approach, results from all studies using different angiogenesis inhibitors will be combined for each comparison. However, a large number of compounds with various mechanisms of actions are currently under development; and treatment effects and toxicity might be different for different substances. For this reason, additional separate analyses will be performed according to their mechanism of action: binding of angiogenic factors, blockade of angiogenic factor receptors, interruption of intracellular signaling pathways, mimetics of endogenous inhibitors and for direct, indirect or mixed inhibitors. This classification will be adopted depending on the availability of relevant studies in the future. In addition, different schedules of angiogenic agents, and combinations of different anti-angiogenic strategies as well as anti-angiogenic therapies with other targeted drugs will be subject of clinical studies and considered if appropriate studies are available.