• Title/Summary/Keyword: Toxicities

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Optimal Scheme of Postoperative Chemoradiotherapy in Rectal Cancer : Phase III Prospective Randomized Trial (직장암의 근치적 수술 후 화학요법과 방사선치료의 순서)

  • Kim Young Seok;Kim Jong Hoon;Choi Eun Kyung;Ahn Seung Do;Lee Sang-Wook;Kim Kyoung-Ju;Lee Je Hwan;Kim Jin Cheon;You Chang Sik;Kim Hee Cheol
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.53-61
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    • 2002
  • Purpose : To determine the optimal scheme of postoperative chemoradiotherapy in rectal cancer by comparing survival, Patterns of failure, toxicities in early and late radiotherapy groups using a Phase III randomized prospective clinical trial. Materials and Methods : From January 1996 to March 1999, 307 patients with curatively resected AJCC stage II and III rectal cancer were assigned randomly to an 'early (151 patients, arm 1)' or a 'late (156 patients, arm II)' and were administered combined chemotherapy (5-FU $375\;mg/m^2/day$, leucovorin $20\;mg/m^2$, IV bolus daily, for 3 days with RT, 5 days without RT, 8 cycles with 4 weeks interval) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Patients of arm I received radiation therapy from day 1 of the first cycle of chemotherapy and those of arm II from day 57 with a third cycle of chemotherapy. The median follow-up period of living patients was 40 months. Results : Of the 307 patients enrolled, fifty patients did not receive scheduled radiation therapy or chemotherapy. The overall survival rate and disease free survival rate at 5 years were $78.3\%\;and\;68.7\%$ in arm I, and $78.4\%\;and\;67.5\%$ in arm II. The local recurrence rate was $6.6\%\;and\;6.4\%$ (p=0.46) in arms I and II, respectively, no significant difference was observed between the distant metastasis rates of the two arms ($23.8\%\;and\;29.5\%$, p=0.16). During radiation therapy, grade 3 diarrhea or more, by the NCI common toxicity criteria, was observed in $63.0\%\;and\;58.2\%$ of the respective arms (p=N.S.), but most were controlled with supportive care. Hematologic toxicity (leukopenia) greater than RTOG grade 2 was found in only $1.3\%\;and\;2.6\%$ of patients in each respective arm. Conclusion : There was no significant difference in survival, patterns of failure or toxicities between the early and late radiation therapy arms. Postoperative adjuvant chemoradiation was found to be a relatively safe treatment but higher compliance is needed.

Postoperative Complications after Preoperative Chemoradiotherapy Combined with Hyperthermia in Locally Advanced Rectal Cancer (국소 진행성 직장암의 수술전 동시 화학방사선치료와 온열치료병합시 수술후 부작용)

  • Yea, Ji Woon
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.89-94
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    • 2014
  • We investigated whether regional hyperthermia (HT) increased post-surgical complications in patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT). Between 1996 and 2007, 205 patients treated with preoperative CCRT and curative surgery were evaluable for the analysis of acute and late toxicities. A total dose of 39.6 Gy or 45 Gy was delivered concurrently with one or two cycles of chemotherapy (5-fluorouracil, leucovorin). Eighty-eight patients received regional HT twice a week using an 8-MHz radiofrequency capacitive heating device. Surgery was performed 4~6 weeks after the completion of preoperative CCRT. The median age was 59 years (range, 18~83) and the median follow-up period was 61months (range, 2~191). The 5-year overall survival and complication-free survival rate of all patients was 77.4% and 73.7%, respectively. Early leakage, delayed leakage, anastomotic stricture, fistula, and small bowel obstruction occurred in 1.0%, 2.9%, 1.5%, 5.9%, and 17.1%, respectively. HT did not increase all kinds of complications. The 5-year complication-free survival rate was 71.8% in the non-HT group and 76.3% in the HT group (p=0.293). Regional HT did not increase postoperative complications in patients with locally advanced rectal cancer treated with preoperative CCRT followed by curative surgery.

Susceptibility of Anthonomus grandis (Cotton Boll Weevil) and Spodoptera frugiperda (Fall Armyworm) to a Cry1Ia-type Toxin from a Brazilian Bacillus thuringiensis Strain

  • Grossi-De-Sa, Maria Fatima;De Magalhaes, Mariana Quezado;Silva, Marilia Santos;Silva, Shirley Margareth.Buffon;Dias, Simoni Campos;Nakasu, Erich Yukio Tempel;Brunetta, Patricia Sanglard Felipe;Oliveira, Gustavo Ramos;De Oliveira Neto, Osmundo Brilhante;De Oliveira, Raquel Sampaio;Soares, Luis Henrique Barros;Ayub, Marco Antonio Zachia;Siqueira, Herbert Alvaro Abreu;Figueira, Edson L.Z.
    • BMB Reports
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    • v.40 no.5
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    • pp.773-782
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    • 2007
  • Different isolates of the soil bacterium Bacillus thuringiensis produce multiple crystal (Cry) proteins toxic to a variety of insects, nematodes and protozoans. These insecticidal Cry toxins are known to be active against specific insect orders, being harmless to mammals, birds, amphibians, and reptiles. Due to these characteristics, genes encoding several Cry toxins have been engineered in order to be expressed by a variety of crop plants to control insectpests. The cotton boll weevil, Anthonomus grandis, and the fall armyworm, Spodoptera frugiperda, are the major economically devastating pests of cotton crop in Brazil, causing severe losses, mainly due to their endophytic habit, which results in damages to the cotton boll and floral bud structures. A cry1Ia-type gene, designated cry1Ia12, was isolated and cloned from the Bt S811 strain. Nucleotide sequencing of the cry1Ia12 gene revealed an open reading frame of 2160 bp, encoding a protein of 719 amino acid residues in length, with a predicted molecular mass of 81 kDa. The amino acid sequence of Cry1Ia12 is 99% identical to the known Cry1Ia proteins and differs from them only in one or two amino acid residues positioned along the three domains involved in the insecticidal activity of the toxin. The recombinant Cry1Ia12 protein, corresponding to the cry1Ia12 gene expressed in Escherichia coli cells, showed moderate toxicity towards first instar larvae of both cotton boll weevil and fall armyworm. The highest concentration of the recombinant Cry1Ia12 tested to achieve the maximum toxicities against cotton boll weevil larvae and fall armyworm larvae were 230 ${\mu}g/mL$ and 5 ${\mu}g/mL$, respectively. The herein demonstrated insecticidal activity of the recombinant Cry1Ia12 toxin against cotton boll weevil and fall armyworm larvae opens promising perspectives for the genetic engineering of cotton crop resistant to both these devastating pests in Brazil.

A 4-Week Oral Toxicity Study of 2-Bromopropane in Sprague- Dawley Male Rats (2-Bromopropane의 수컷 랫트를 이용한 4주간 반복 경구투여 아급성독성실험)

  • 이현숙;강부현;손화영;김희연;조영채;노정구
    • Toxicological Research
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    • v.14 no.2
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    • pp.129-141
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    • 1998
  • Toxic effects of 2-bromopropane (2-BP) on the hematopoietic system and testis were investigated in male Srague-Dawley (SD) rats. 80 male SD rats, 5 weeks old, were treated with 2-BP in corn oil at levels of 0, 100, 330 and 1,000 mg/kg/day for 4 weeks orally. 10 animals from each group were maintained for additional 8 weeks following the treatment. In addition, 60 male SD rats were divided into 2 groups and administered 2-BP in corn oil at levels of 0 and 1,000 mg/kg/day orally and sacrificed after 1. 2 and 3 weeks of treatment. Clinical observation. body weight changes, food consumption, organ weight changes. hematology, serum chemistry and histopathology of the testis were performed in the study. No clinical sign and mortality were observed in the study. The body weights were significantly reduced with the treatment but gradually recovered. The relative organ weights of the testis and thymus significantly decreased in both of the groups treated with 1,000 mg/kg/day for 3 and 4 weeks. In the recovery groups, organ weights of the testis and epididymis were significantly reduced in both of the groups treated with 330 and 1,000 mg/kg/day. Platelets and reticulocytes were significantly reduced in both of the group treated with 1.000 mg/kg/day for 3 and 4 weeks. While red blood cells were de-creased but mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were increased in the recovery group. Significant increase of chloride was observed in all of the treatment groups except the recovery groups, and calcium was significantly increased in both of the groups treated with 1,000 mg/kg/ day for 3 and 4 weeks. On the other hand. there were significant decreases in alanine aminotransferase (ALT) and aspatate aminotransferase (AST) in most of groups treated with 1.000 mg/kg/day. In the testis. the spermatogonia in stages I-VI were mostly depleted and the spermatocytes in stages VII-VIII were de-generated or necrotized at week 1 after treatment of 2-BP. The degeneration of germ cells and the a-trophy of seminiferous tubules became more severe in time-dependent and dose-dependent manners. The damaged tubules showed regeneration in part. however. they did not appear to be completely recovered within 8 weeks of the recovery period. On the basis of the results. it is suggested that 2-BP would cause toxicities in hematopoiesis by possibly interfering the production of red blood cells and platelets and in spermatogenesis by the destruction oj spermatogonia in SD male rats.

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Effect of Ultraviolet-B Radiation Acclimation to Fresh Water Daphnia magna Simultaneously Exposed to Several Heavy Metals and UV-B Radiation (담수 물벼룩 Daphnia magna의 자외선 B 적응이 자외선과 중금속의 동시노출에 따른 독성반응에 미치는 영향)

  • Kim, Jung-Kon;Lee, Min-Jung;Oh, So-Rin;Choi, Kyung-Ho
    • Journal of Environmental Health Sciences
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    • v.33 no.2 s.95
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    • pp.123-131
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    • 2007
  • Many environmental contaminants including several metals, polycyclic aromatic hydrocarbons, and pharmaceuticals, have been identified to be phototoxic in the water environment. Concerns regarding photo-enhancement of toxicity of several environmental contaminants have been increasing because of the increased level of ultraviolet irradiation on the earth surface. However, there exist arguments that there might be certain defense mechanisms taking place in the aquatic ecosystem, which may include behavioral characteristics or genetic acclimation. This study was conducted to understand the potential responses of aquatic receptors to several phototoxic metals in the real environment, where long-term acclimation of such organisms to low dose UV-B may take place. For this purpose, water flea Daphnia magna was acclimated to environmentally relevant dose of UV-B (12 to $18uW/cm^2$) for >11 generations. The differences in developmental and life history characteristics, and toxicity responses were evaluated. Acclimation did not affect the daphnids' growth, longevity, and reproduction characteristics such as time to first brood, and brood size: After 21 d, survival of D. magna was not influenced by UV-B acclimation. When the number of young per female was compared. the daphnids acclimated for 11 generations tend to produce less number of neonates than the un-acclimated individuals but with no statistical significance (p>0.05). Four metals that were reported to be phototoxic elsewhere were employed in this evaluation, that include As, Cd. Cu, and Ni. UV-B level being applied in acclimation did increase the toxicity of Cd and Cu, significantly (p<0.05). However, the toxicities of As and Ni were not affected by irradiation of UV-B. Phototoxic responses were evaluated between the acclimated and the un-acclimated daphnids. For Cu, UV-B acclimation led to reduction of the photo-induced toxicity $(p\approx0.1)$ in daphnids. Non-acclimated Daphnia were affected by 50% at 4.18 ug/l Cu. but UV-B acclimated individuals exhibited $EC_{50}$ of 5.89 ug/l. With Cd, UV-B acclimation appeared to increase phototoxicity (p>0.05). With As and Ni, UV-B acclimation did not influence photo-induced toxicity. This observation may be in part explained by the type of reactive oxygen species that were generated by each metal. Similar to UV-B light, Cu is known to generate superoxide anion by acting as redox cycling toxicant. This is one of the first studies that employed_laboratory based UV-B acclimated test species for photoenhanced toxicity evaluation.

Treatment Outcomes of Paclitaxel for Refractory or Recurrent Epithelial Ovarian Cancer Patients in Thailand

  • Pitakkarnkul, Supakorn;Tangjitgamol, Siriwan;Srijaipracharoen, Sunamchok;Manusirivithaya, Sumonmal;Pataradool, Kamol;Prutthiphongsit, Watchara;Khunnarong, Jakkapan;Thavaramara, Thaovalai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2421-2427
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    • 2013
  • Background: To study the response rate, toxicity profiles, and survival of refractory or recurrent epithelial ovarian cancer (EOC) patients treated with paclitaxel. Materials and Methods: Patients with refractory or recurrent EOC who were treated with paclitaxel between January 2002 and December 2011 at the Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital were identified. Clinicopathological features of the patients including detailed data of paclitaxel treatment were collected. Results: During the study period, a total of 44 patients were identified, with a mean age of $52.9{\pm}8.2$ years. Some 13.6% (six patients) had refractory cancer to first-line chemotherapy while 86.4% (38 patients) had recurrent cancer. Among these, 35 (79.6%) and 9 (20.4%) patients were considered as platinum-sensitive and platinum-resistant, respectively. Three patients (6.8%) received fewer than 2 cycles of paclitaxel due to loss to follow-up, leaving 41 patients evaluable for response. The overall response rate observed in all 41 patients was 41.5% (17 patients; 12 complete and five partial responses): 12.5% or 1/8 patients with refractory or platinum-resistant cancer and 48.5% or 16/33 patients with platinum-sensitive disease. Stable disease was demonstrated in 17.0% (seven patients) while progressive disease was apparent in 41.5% (17 patients). Median time to progress was 4.5 months (range, 0.67-58.6 months). Median progression-free survival was not reached while median overall survival was 16.3 months (95% confidence interval, 11.0 months -21.6 months). Common toxicities were neutropenia, neuropathy, and alopecia. Conclusions: Paclitaxel is an active agent for refractory or recurrent EOC. Neutropenia, neuropathy and alopecia are common side effects.

Xeliri Plus Bevacizumab Compared with Folfiri Plus Bevacizumab as First-Line Setting in Patients with Metastatic Colorectal Cancer: Experiences at Two-Institutions

  • Uygun, Kazim;Bilici, Ahmet;Kaya, Serap;Ustaalioglu, Bala Basak Oven;Yildiz, Ramazan;Temiz, Suleyman;Seker, Mesut;Aksu, Gorkem;Cabuk, Devrim;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2283-2288
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    • 2013
  • Background: Efficacy of chemotherapy plus bevacizumab has been shown in patients with metastatic colorectal cancer (mCRC) compared with chemotherapy alone. The aim of the present study was to evaluate the efficacy and safety of FOLFIRI or XELIRI regimens in combination with bevacizumab for mCRC patients in a first-line setting. Materials and Methods: A total of 132 patients with previously untreated and histologically confirmed mCRC were included. They were treated with either FOLFIRI-Bevacizumab (Bev) or XELIRI-Bev according to physician preference. The efficacy and safety of the two regimens were compared. Results: Between 2006 and 2010, 68 patients were treated with the XELIRI-Bev regimen, while the remaining 64 patients received the FOLFIRI-Bev regimen. The median age was 58.5 years (53.6 years in the FOLFIRI-Bev and 59.7 years in the XELIRI-Bev arm, p=0.01). Objective response rate was 51.6% for FOLFIRI-Bev versus 41.2% for XELIRI-Bev (p=0.38). At the median follow-up of 24.5 months, the median progression-free survival (PFS) was not different between two groups (14.2 months in FOLFIRI-Bev vs. not reached in the XELIRI-Bev, p=0.30). However, median overall survival time for the FOLFIRI-Bev arm was better than that for patients treated with XELIRIBev, but these differences was not statistically significant (37.8 months vs. 28.7 months, respectively, p=0.58). Most commonly reported grade 3-4 toxicities (FOLFIRI-Bev vs XELIRI-Bev) were nausea/vomiting (7.8% vs. 14.7%, p=0.27), diarrhea (10.9% vs 22.1%, p=0.10), hand-foot syndrome (0% vs 8.8%, p=0.02) and neutropenia (18.7% vs 27.9%, p=0.22). Conclusion: Our results showed that FOLFIRI-Bev and XELIRI-Bev regimens were similarly effective treatments in a first-line setting for patients with untreated mCRC, with manageable adverse event profiles.

Evaluation of Insecticidal Activity of Pesticides Against Hemipteran Pests on Apple Orchard (사과과수원의 노린재류에 대한 농약의 생물활성 평가)

  • Lee, Sun-Young;Yoon, Changmann;Do, Yun-Su;Lee, Dong-Hyuk;Lee, Jung-Sup;Choi, Kyung-Hee
    • The Korean Journal of Pesticide Science
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    • v.19 no.3
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    • pp.264-271
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    • 2015
  • Stink bugs do damage on various crops including upland crops and tree fruits. Especially, yellow-brown stink bug (Halyomorpha halys ($St{\aa}l$)) and brown-winged green (Plautia stali) are severely damaged on apple orchard. Using seven insecticides - dinotefuran WP, etofenprox WP, chlorpyrifos WP, cabaryl WP, chlothianidin SC, flonicamid WG, and bifenthrin WG - registered on apple, contact and residual toxicities were tested on both male and female of P. stali and H. halys that preferred apple fruit. Contact toxicity of dinotefuran WP was excellent on male P. stali 48 hours after treatment (HAT) with 96.7% and significant on male Halyomorpha halys 48 HAT with 74.5% but the others had low effect. Contact toxicity on these stink bugs were higher in male than female. All insecticides except flonicamid, residual effects were all effective on both male and female of P. stali, while chlorpyrifos and bifenthrin were showed higher residual toxicity on both male and female of H. halys in laboratory condition. Two insecticides, chlorpyrifos and bifenthrin, were selected for the field test. Bifenthrin have a high residual effect on P. stali until 5 days after treatment, but have a low residual toxicity on H. halys in the field test. Chlorpyrifos showed higher residual toxicity in the laboratory, however, showed low residual efficacy on two species stink bug onto the field.

Efficacy and Toxicity of Gemcitabine Plus Docetaxel Combination as a Second Line Therapy for Patients with Advanced Stage Soft Tissue Sarcoma

  • Ali Osman, Kaya;Suleyman, Buyukberber;Metin, Ozkan;Necati, Alkis;Alper, Sevinc;Nuriye Yildirim, Ozdemir;Suleyman, Alici;Onur, Esbah;Veli, Berk;Celalettin, Camci;Arife, Ulas;Ugur, Coskun;Mustafa, Benekli
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.463-467
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    • 2012
  • Purpose: To assess the safety and efficacy of a gemcitabine plus docetaxel regimen as a second line therapy for patients with advanced soft tissue sarcoma (STS) resistant to doxorubicin and ifosfamide-based therapy. Patients and Methods: Medical records of 64 patients with advanced STS who received gemcitabine plus docetaxel regimen as a second line treatment between May 2006 and June 2011 were examined. All patients had been previously treated with doxorubicin plus ifosfamide-based regimen at first line setting. Patients received gemcitabine 900 $mg/m^2$ on days one and eight intravenously over 90 minutes, followed by docetaxel 75 $mg/m^2$ on day eight intravenously over one hour. Cycles were repeated every 3 weeks. Results: The male-to-female ratio was 37/27 and the median age was 44 years (range; 19-67 years). Objective responses were observed in 13 (20.3 %) patients (2 CR, 11 PR) and stable disease in 21 (32.8 %). Total clinical benefit (CR+PR+SD) was observed in 34 (53.1 %). Median overall survival (OS) was 18 months (95% confidence interval (CI):12.1-23.9) and Median time to progression (TTP) was 4.8 months (95% CI: 3.6-6). A total of 243 cycles of chemotherapy were administered. The median number of cycle was 3 (range;1-11). The most common grade 3-4 hematologic toxicity was neutropenia (35.9 %). The most common nonhematologic toxicities consisted of nausea/vomiting (37.5 %), mucositis (32.8 %), peripheral neuropathy (29.7%), and fatigue (26 %). There was no toxicity-related death. Conclusion: The combination of gemcitabine plus docetaxel is an active and tolerable regimen as a second line therapy for patients with advanced soft tissue sarcoma who have failed doxorubicin and ifosfamide-based therapy.

Efficacy and Toxicity of Anti-VEGF Agents in Patients with Castration-Resistant Prostate Cancer: a Meta-analysis of Prospective Clinical Studies

  • Qi, Wei-Xiang;Fu, Shen;Zhang, Qing;Guo, Xiao-Mao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8177-8182
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    • 2014
  • Background: Blocking angiogenesis by targeting vascular endothelial growth factor (VEGF) signaling pathway to inhibit tumor growth has proven to be successful in treating a variety of different metastatic tumor types, including kidney, colon, ovarian, and lung cancers, but its role in castration-resistant prostate cancer (CRPC) is still unknown. We here aimed to determine the efficacy and toxicities of anti-VEGF agents in patients with CRPC. Materials and Methods: The databases of PubMed, Web of Science and abstracts presented at the American Society of Clinical Oncology up to March 31, 2014 were searched for relevant articles. Pooled estimates of the objective response rate (ORR) and prostate-specific antigen (PSA) response rate (decline ${\geq}50%$) were calculated using the Comprehensive Meta-Analysis (version 2.2.064) software. Median weighted progression-free survival (PFS) and overall survival (OS) time for anti-VEGF monotherapy and anti-VEGF-based doublets were compared by two-sided Student's t test. Results: A total of 3,841 patients from 19 prospective studies (4 randomized controlled trials and 15 prospective nonrandomized cohort studies) were included for analysis. The pooled ORR was 12.4% with a higher response rate of 26.4% (95%CI, 13.6-44.9%) for anti-VEGF-based combinations vs. 6.7% (95%CI, 3.5-12.7%) for anti-VEGF alone (p=0.004). Similarly, the pooled PSA response rate was 32.4% with a higher PSA response rate of 52.8% (95%CI: 40.2-65.1%) for anti-VEGF-based combinations vs. 7.3% (95%CI, 3.6-14.2%) for anti-VEGF alone (p<0.001). Median PFS and OS were 6.9 and 22.1 months with weighted median PFS of 5.6 vs. 6.9 months (p<0.001) and weighted median OS of 13.1 vs. 22.1 months (p<0.001) for anti-VEGF monotherapy vs. anti-VEGF-based doublets. Conclusions: With available evidence, this pooled analysis indicates that anti-VEGF monotherapy has a modest effect in patients with CRPC, and clinical benefits gained from anti-VEGF-based doublets appear greater than anti-VEGF monotherapy.