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Chemotherapy or Targeted Therapy as Second-Line Treatment of Advanced Gastric Cancer. A Systematic Review and Meta-Analysis of Published Studies

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  • Roberto Iacovelli
  • Filippo Pietrantonio
  • Alessio Farcomeni
  • Claudia Maggi
  • Antonella Palazzo
  • Francesca Ricchini
  • Filippo de Braud
  • Maria Di Bartolomeo

Abstract

Chemotherapy is a cornerstone in treatments of gastric cancer, but despite its benefit, less than 60% of patients receive salvage therapy in clinical practice. We performed a systematic review and meta-analysis based on trial data on the role of second-line treatment of advanced gastric cancer. MEDLINE/PubMed and Cochrane Library were searched for randomized phase III trials that compared active therapy to best supportive care in advanced gastric cancer. Data extraction was conducted according to the PRISMA statement. Summary HR for OS was calculated using a hierarchical Bayesian model and subgroup analysis was performed based on baseline Eastern Cooperative Oncology Group Performance Status (ECOG) performance status (0 vs. 1 or more). A total of 1,407 patients were evaluable for efficacy, 908 were treated in the experimental arms, with chemotherapy (231 pts) or with targeted therapies (677 pts). The risk of death was decreased by 18% (HR = 0.82; 95% CI, 0.79–0.85; posterior probability HR≥1:

Suggested Citation

  • Roberto Iacovelli & Filippo Pietrantonio & Alessio Farcomeni & Claudia Maggi & Antonella Palazzo & Francesca Ricchini & Filippo de Braud & Maria Di Bartolomeo, 2014. "Chemotherapy or Targeted Therapy as Second-Line Treatment of Advanced Gastric Cancer. A Systematic Review and Meta-Analysis of Published Studies," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-7, September.
    • Handle: RePEc:plo:pone00:0108940
    DOI: 10.1371/journal.pone.0108940
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Julian P. T. Higgins & Simon G. Thompson & David J. Spiegelhalter, 2009. "A re‐evaluation of random‐effects meta‐analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(1), pages 137-159, January.
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