Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2023; 15(5): 906-916
Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.906
Retrospective efficacy analysis of olaparib combined with bevacizumab in the treatment of advanced colorectal cancer
Yi-Ling Jiang, Xue-Yuan Fu, Zhi-Hui Yin
Yi-Ling Jiang, Department of Oncology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, Hunan Province, China
Xue-Yuan Fu, Zhi-Hui Yin, Department of Anorectal, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, Hunan Province, China
Author contributions: Jiang YL drafted the manuscript; Jiang YL and Fu XY collected and analyzed the clinical data; Yin ZH designed the study, reviewed and revised the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of The First Affiliated Hospital, Hengyang Medical School, University of South China.
Informed consent statement: The data used in this study were not involved in the patients’ private information, so the informed consent was waived by the Ethics Committee of The First Affiliated Hospital, Hengyang Medical School, University of South China. All patient data obtained, recorded and managed are only used for this study, and all patient information is strictly confidential, without any harm to the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Hui Yin, MM, Associate Chief Physician, Department of Anorectal, The First Affiliated Hospital, Hengyang Medical School, University of South China, No. 69 Chuanshan Avenue, Shigu District, Hengyang 421001, Hunan Province, China. yinzhihui6996@163.com
Received: February 19, 2023
Peer-review started: February 19, 2023
First decision: March 1, 2023
Revised: March 11, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 27, 2023
Abstract
BACKGROUND

Colorectal cancer (CRC) is a highly prevalent malignancy of the digestive tract worldwide, characterized by a significant morbidity and mortality rate and subtle initial symptoms. Diarrhea, local abdominal pain, and hematochezia occur with the development of cancer, while systemic symptoms such as anemia and weight loss occur in patients with advanced CRC. Without timely interventions, the disease can have fatal consequences within a short span. The current therapeutic options for colon cancer include olaparib and bevacizumab, which are widely utilized. This study intends to evaluate the clinical efficacy of olaparib combined with bevacizumab in the treatment of advanced CRC, hoping to provide insights into advanced CRC treatment.

AIM

To investigate the retrospective efficacy of olaparib combined with bevacizumab in the treatment of advanced CRC.

METHODS

A retrospective analysis was conducted on a cohort of 82 patients with advanced colon cancer who were admitted to the First Affiliated Hospital of the University of South China between January 2018 and October 2019. Among them, 43 patients subjected to the classical FOLFOX chemotherapy regimen were selected as the control group, and 39 patients undergoing treatment with olaparib combined with bevacizumab were selected as the observation group. Subsequent to different treatment regimens, the short-term efficacy, time to progression (TTP), and incidence rate of adverse reactions between the two groups were compared. Changes in serum-related indicators [vascular endothelial growth factor (VEGF), matrix metalloprotein-9 (MMP-9), cyclooxygenase-2 (COX-2)] and tumor markers [human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199)] levels before and after treatment were compared between the two groups at the same time.

RESULTS

The objective response rate was discovered to be 82.05%, and the disease control rate was 97.44% in the observation group, which were significantly higher than the respective rates of 58.14% and 83.72% in the control group (P < 0.05). The median TTP was 24 mo (95%CI: 19.987-28.005) in the control group and 37 mo (95%CI: 30.854-43.870) in the observation group. The TTP in the observation group was significantly better than that in the control group, and the difference held statistical significance (log-rank test value = 5.009, P = 0.025). Before treatment, no substantial difference was detected in serum VEGF, MMP-9, and COX-2 levels and tumor markers HE4, CA125, and CA199 levels between the two groups (P > 0.05). Following treatment with different regimens, the above indicators in the two groups were remarkably promoted (P < 0.05), VEGF, MMP-9, and COX-2 in the observation group were lower than those in the control group (P < 0.05), and HE4, CA125, and CA199 levels were also lower than those in the control group (P < 0.05). Vis-à-vis the control group, the total incidence of gastrointestinal reactions, thrombosis, bone marrow suppression, liver and kidney function injury, and other adverse reactions in the observation group was notably lowered, with the difference considered statistically significant (P < 0.05).

CONCLUSION

Olaparib combined with bevacizumab in the treatment of advanced CRC demonstrates a strong clinical effect of delaying disease progression and reducing the serum levels of VEGF, MMP-9, COX-2 and tumor markers HE4, CA125 and CA199. Moreover, given its fewer adverse reactions, it can be regarded as a safe and reliable treatment option.

Keywords: Olaparib, Bevacizumab, Advanced colorectal cancer, Efficacy

Core Tip: Colorectal cancer (CRC) presents insignificant symptoms in the early stage and is commonly diagnosed in the middle and advanced stages. Therefore, surgery is usually not viable because the best timing is missed, and chemotherapy, targeted therapies and other regimens are often utilized as interventions. Olaparib and bevacizumab are common targeted therapies with excellent therapeutic effects in a variety of solid tumors. This research collected the clinical data of 82 patients with advanced CRC, retrospectively investigated the clinical efficacy and safety of olaparib combined with bevacizumab in advanced CRC treatment, and analyzed the effect of this treatment regimen on the serum levels of vascular endothelial growth factor, matrix metalloprotein-9, cyclooxygenase-2, and related tumor markers.