OBJECTIVE: To evaluate the impact on overall survival at 6, 12 and 18 months of gemcitabine-based doublets compared with gemcitabine alone in patients with advanced and metastatic pancreatic cancer. METHODS: We conducted a systematic review and meta-analysis of published data on the use of gemcitabine-based doublets compared with gemcitabine alone in chemotherapy-naive patients with advanced and metastatic pancreatic cancer treated in randomised controlled phase II-III trials with overall survival as the principal or secondary endpoint. To this end, a literature search was performed using Cochrane methodology. The relative risks with 95% confidence intervals were estimated based on adjusted number of deaths and patients at risk according to the extent of follow-up and censoring. Twenty-three randomised clinical trials including 5886 patients met the inclusion criteria. In these trials, 2932 patients were randomly assigned to receive gemcitabine-based doublets and 2954 patients to receive gemcitabine alone. RESULTS: Gemcitabine-based doublets were associated with small but significant reductions in the risk of death at 6, 12 and 18 months of 8% (95% CI 3, 13), 4% (95% CI 2, 7) and 3% (95% CI 1, 5), respectively (p<0.005 for all timepoints). No heterogeneity between studies was observed. Subgroup analyses showed an overall survival benefit for gemcitabine-based doublets in clinical trials testing the same planned dose intensity of gemcitabine in comparative arms, using platinum salt-based protocols and with survival as the primary endpoint. CONCLUSION: This meta-analysis of data obtained from randomised controlled phase II-III trials of patients with advanced pancreatic cancer showed a small but significant improvement in overall survival for patients receiving gemcitabine-based doublets compared with gemcitabine alone.
OBJECTIVE: To evaluate the impact on overall survival at 6, 12 and 18 months of gemcitabine-based doublets compared with gemcitabine alone in patients with advanced and metastatic pancreatic cancer. METHODS: We conducted a systematic review and meta-analysis of published data on the use of gemcitabine-based doublets compared with gemcitabine alone in chemotherapy-naive patients with advanced and metastatic pancreatic cancer treated in randomised controlled phase II-III trials with overall survival as the principal or secondary endpoint. To this end, a literature search was performed using Cochrane methodology. The relative risks with 95% confidence intervals were estimated based on adjusted number of deaths and patients at risk according to the extent of follow-up and censoring. Twenty-three randomised clinical trials including 5886 patients met the inclusion criteria. In these trials, 2932 patients were randomly assigned to receive gemcitabine-based doublets and 2954 patients to receive gemcitabine alone. RESULTS:Gemcitabine-based doublets were associated with small but significant reductions in the risk of death at 6, 12 and 18 months of 8% (95% CI 3, 13), 4% (95% CI 2, 7) and 3% (95% CI 1, 5), respectively (p<0.005 for all timepoints). No heterogeneity between studies was observed. Subgroup analyses showed an overall survival benefit for gemcitabine-based doublets in clinical trials testing the same planned dose intensity of gemcitabine in comparative arms, using platinum salt-based protocols and with survival as the primary endpoint. CONCLUSION: This meta-analysis of data obtained from randomised controlled phase II-III trials of patients with advanced pancreatic cancer showed a small but significant improvement in overall survival for patients receiving gemcitabine-based doublets compared with gemcitabine alone.
Authors: E Van Cutsem; H van de Velde; P Karasek; H Oettle; W L Vervenne; A Szawlowski; P Schoffski; S Post; C Verslype; H Neumann; H Safran; Y Humblet; J Perez Ruixo; Y Ma; D Von Hoff Journal: J Clin Oncol Date: 2004-04-15 Impact factor: 44.544
Authors: Jordan D Berlin; Paul Catalano; James P Thomas; John W Kugler; Daniel G Haller; Al Bowen Benson Journal: J Clin Oncol Date: 2002-08-01 Impact factor: 44.544
Authors: Caio M Rocha Lima; Mark R Green; Robert Rotche; Wilson H Miller; G Mark Jeffrey; Laura A Cisar; Adele Morganti; Nicoletta Orlando; Gabriela Gruia; Langdon L Miller Journal: J Clin Oncol Date: 2004-09-15 Impact factor: 44.544
Authors: M Hidalgo; A Abad; E Aranda; L Díez; J Feliu; C Gómez; A Irigoyen; R López; F Rivera; C Rubio; J Sastre; J Tabernero; E Díaz-Rubio Journal: Clin Transl Oncol Date: 2009-05 Impact factor: 3.405
Authors: Gillian K Gresham; George A Wells; Sharlene Gill; Christopher Cameron; Derek J Jonker Journal: BMC Cancer Date: 2014-06-27 Impact factor: 4.430