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Does gemcitabine-based combination therapy improve the prognosis of unresectable pancreatic cancer?

Sun, Chen LU ; Ansari, Daniel LU ; Andersson, Roland LU and Wu, De-Quan (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)
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author
organization
publishing date
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
2012-12-03 07:10:49
date last changed
2017-10-01 03:07:05
@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 &lt; 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},
  keyword      = {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},
  volume       = {18},
  year         = {2012},
}