Does gemcitabine-based combination therapy improve the prognosis of unresectable pancreatic cancer?
(2012) In World Journal of Gastroenterology 18(35). p.4944-4958- Abstract
- AIM: To assess whether gemcitabine-based combination therapy improves the prognosis of unresectable pancreatic cancer compared with gemcitabine treatment alone. METHODS: A quantitative up-to-date meta-analysis was undertaken to investigate the efficacy of gemcitabine-based combination treatment compared with gemcitabine monotherapy in locally advanced or metastatic pancreatic cancer. Inclusion was limited to high-quality randomized clinical trials. RESULTS: Twenty-six studies were included in the present analysis, with a total of 8808 patients recruited. The studies were divided into four subgroups based on the different kinds of cytotoxic agents, including platinum, fluoropyrimidine, camptothecin and targeted agents. Patients treated with... (More)
- AIM: To assess whether gemcitabine-based combination therapy improves the prognosis of unresectable pancreatic cancer compared with gemcitabine treatment alone. METHODS: A quantitative up-to-date meta-analysis was undertaken to investigate the efficacy of gemcitabine-based combination treatment compared with gemcitabine monotherapy in locally advanced or metastatic pancreatic cancer. Inclusion was limited to high-quality randomized clinical trials. RESULTS: Twenty-six studies were included in the present analysis, with a total of 8808 patients recruited. The studies were divided into four subgroups based on the different kinds of cytotoxic agents, including platinum, fluoropyrimidine, camptothecin and targeted agents. Patients treated with gemcitabine monotherapy had significantly lower objective response rate [risk ratio (RR), 0.72; 95% confidence interval (CI): 0.63-0.83; P < 0.001], and lower 1-year overall survival (RR, 0.90; 95%CI: 0.82-0.99; P = 0.04). Gemcitabine monotherapy caused fewer complications, including fewer grade 3-4 toxicities: including vomiting (RR, 0.75; 95%CI: 0.62-0.89; P = 0.001), diarrhea (RR, 0.66; 95%CI: 0.49-0.89; P = 0.006), neutropenia (RR, 0.88; 95%CI: 0.72-1.06; P = 0.18), anemia (RR, 0.96; 95%CI: 0.82-1.12; P = 0.60), and thrombocytopenia (RR, 0.76; 95%CI: 0.60-0.97; P = 0.03) compared with gemcitabine combination therapies. CONCLUSION: Gemcitabine combination therapy provides a modest improvement of survival, but is associated with more toxicity compared with gemcitabine monotherapy. (C) 2012 Baishideng. All rights reserved. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3190158
- author
- Sun, Chen LU ; Ansari, Daniel LU ; Andersson, Roland LU and Wu, De-Quan
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Pancreatic cancer, Gemcitabine, Combination therapy, Outcome, Meta-analysis
- in
- World Journal of Gastroenterology
- volume
- 18
- issue
- 35
- pages
- 4944 - 4958
- publisher
- WJG Press
- external identifiers
-
- wos:000309099500015
- scopus:84867800359
- ISSN
- 1007-9327
- DOI
- 10.3748/wjg.v18.i35.4944
- language
- English
- LU publication?
- yes
- id
- 59b26c9d-976d-4b9d-b911-de6846ecaf5b (old id 3190158)
- date added to LUP
- 2016-04-01 10:05:16
- date last changed
- 2022-01-25 19:34:29
@article{59b26c9d-976d-4b9d-b911-de6846ecaf5b, abstract = {{AIM: To assess whether gemcitabine-based combination therapy improves the prognosis of unresectable pancreatic cancer compared with gemcitabine treatment alone. METHODS: A quantitative up-to-date meta-analysis was undertaken to investigate the efficacy of gemcitabine-based combination treatment compared with gemcitabine monotherapy in locally advanced or metastatic pancreatic cancer. Inclusion was limited to high-quality randomized clinical trials. RESULTS: Twenty-six studies were included in the present analysis, with a total of 8808 patients recruited. The studies were divided into four subgroups based on the different kinds of cytotoxic agents, including platinum, fluoropyrimidine, camptothecin and targeted agents. Patients treated with gemcitabine monotherapy had significantly lower objective response rate [risk ratio (RR), 0.72; 95% confidence interval (CI): 0.63-0.83; P < 0.001], and lower 1-year overall survival (RR, 0.90; 95%CI: 0.82-0.99; P = 0.04). Gemcitabine monotherapy caused fewer complications, including fewer grade 3-4 toxicities: including vomiting (RR, 0.75; 95%CI: 0.62-0.89; P = 0.001), diarrhea (RR, 0.66; 95%CI: 0.49-0.89; P = 0.006), neutropenia (RR, 0.88; 95%CI: 0.72-1.06; P = 0.18), anemia (RR, 0.96; 95%CI: 0.82-1.12; P = 0.60), and thrombocytopenia (RR, 0.76; 95%CI: 0.60-0.97; P = 0.03) compared with gemcitabine combination therapies. CONCLUSION: Gemcitabine combination therapy provides a modest improvement of survival, but is associated with more toxicity compared with gemcitabine monotherapy. (C) 2012 Baishideng. All rights reserved.}}, author = {{Sun, Chen and Ansari, Daniel and Andersson, Roland and Wu, De-Quan}}, issn = {{1007-9327}}, keywords = {{Pancreatic cancer; Gemcitabine; Combination therapy; Outcome; Meta-analysis}}, language = {{eng}}, number = {{35}}, pages = {{4944--4958}}, publisher = {{WJG Press}}, series = {{World Journal of Gastroenterology}}, title = {{Does gemcitabine-based combination therapy improve the prognosis of unresectable pancreatic cancer?}}, url = {{http://dx.doi.org/10.3748/wjg.v18.i35.4944}}, doi = {{10.3748/wjg.v18.i35.4944}}, volume = {{18}}, year = {{2012}}, }