BACKGROUND: Epithelial growth factor receptor inhibitors (EGFRis) and bevacizumab ( @entity1493 ) are used in combination with chemotherapy for the treatment of metastatic @entity14 (mCRC). However, few randomized controlled trials (RCTs) have directly compared their relative efficacy on progression-free survival (PFS) and @entity1349 ( @entity1349 ). METHODS: We conducted a systematic review of first-line RCTs comparing (1) EGFRis vs. @entity1493 , with chemotherapy in both arms (2) EGFRis + chemotherapy vs. chemotherapy alone, or (3) @entity1493 + chemotherapy vs. chemotherapy alone, using Cochrane methodology. Data on and PFS and @entity1349 were extracted using the Parmar method. Pairwise meta-analyses and Bayesian network meta-analyses (NMA) were conducted to estimate the direct, indirect and combined PFS and @entity1349 hazard ratios (HRs) comparing EGFRis to @entity1493 . RESULTS: Seventeen RCTs contained extractable data for quantitative analysis. Combining direct and indirect data using an NMA did not show a statistical difference between EGFRis versus @entity1493 (PFS HR = 1.11 (95% CR: 0.92-1.36) and @entity1349 HR = 0.91 (95% CR: 0.75-1.09)). Direct meta-analysis (3 RCTs), indirect (14 RCTs) and combined (17 RCTs) NMA of PFS HRs were concordant and did not show a difference between EGFRis and @entity1493 . Meta-analysis of @entity1349 using direct evidence, largely influenced by one trial, showed an improvement with EGFRis therapy (HR = 0.79 (95% CR: 0.65-0.98)), while indirect and combined NMA of @entity1349 did not show a difference between EGFRis and @entity1493 Successive inclusions of trials over time in the combined NMA did not show superiority of EGFRis over @entity1493 . CONCLUSIONS: Our findings did not support @entity1349 or PFS benefits of EGFRis over @entity1493 in first-line mCRC.

A Systematic Review and Network Meta-Analysis of Biologic Agents in the First Line Setting for Advanced XXXX .

@entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal cancer'] @entity1493 :: ('12064', 'Species') :: ['BEV'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['overall survival', 'OS']
@entity14 :: (MESH:D015179,Disease) :: ['Colorectal Cancer']
