Evidence-based Evaluation on Off-label Drug Use of Rituximab Combined with Irinotecan in the Treatment of Advanced Colorectal Cancer

OBJECTIVE To systematic evaluate the rationality of off-label drug use of rituximab combined with irinotecan in the treatment of advanced colorectal cancer. METHODS To search the latest edition of the drug instructions, authoritative guidelines and diagnosis and treatment specifications of the domestic and foreign websites of retictx and irinotecan, collected all indications of reticetrexed and irinotecan. PubMed, EMbase, Cochrane library, Epistemonikos, CBM, CNKI, VIP and Wanfang database were searched from database foundation to October 2016, collection of rituximab combined with irinotecan in the treatment of advanced colorectal cancer off label drug use research literatures, a systematic evaluation of the efficacy and safety of the drug in the treatment of advanced colorectal cancer. RESULTS The edition of irinotecan medicine instructions were not found about treatment of advanced colorectal cancer in the CFDA drug instruction. There was no guide recommended raltitrexed combined with irinotecan for the treatment of advanced colorectal cancer. Only one systematic review published in 2014, including 12 randomized trials and 10 prospective cohort studies with a sample size of 735 and an AMSTAR score of 6. The study found that raltitrexed combined with oxaliplatin and raltitrexed combined with irinotecan in the treatment of advanced colorectal cancer had no significant difference in the effective, overall survival time, disease progression-free survival time. CONCLUSION At present, there is a low level of evidence for rituximab combined with irinotecan treatment in advanced colorectal cancer. It still needs to carry out a large sample of randomized controlled trials to confirm the effectiveness and potential serious safety problems of rituximab combined with irinotecan, it is suggested that advanced colorectal cancer shall be avoided using.