Abstract |
The standard treatment for patients with advanced gastric cancer (AGC) is still debated, and the available data on the benefit of irinotecan-containing regimen as first-line treatment for those patients are controversial. We performed a systematic review and meta-analysis of randomized controlled trials to determine the survival benefits of irinotecan-containing regimens in this setting. A total of 1,837 patients from ten trials were included in the analysis. Our results showed that irinotecan-containing regimens significantly improved overall survival [OS: hazard ratio (HR) 0.86, 95% CI = 0.78-0.94, p = 0.002] and progression-free survival [HR = 0.82, 95% CI = 0.69-0.97, p = 0.026); however, the improvement of time to failure (HR = 0.90; 95% CI = 0.77-1.04, p = 0.15), 1-year survival rate [1-year SR: relative risk (RR) 1.10, 95% CI = 0.97-1.24, p = 0.13] and overall response rate (RR = 1.16, 95% CI = 0.91-1.49, p = 0.24] were nonsignificant. Equivalent frequencies of toxicities were found between the two groups excluding more Grade 3 or 4 fatigue (p = 0.001) in irinotecan-containing regimens. This updated meta-analysis provided strong evidence for a survival benefit of irinotecan-containing regimen as first-line treatment for AGC. A clear advantage of irinotecan-containing over nonirinotecan-containing regimen had not been established. These results should help to inform decisions about patient management and design of future trials.
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Authors | Wei-Xiang Qi, Zan Shen, Feng Lin, Yuan-Jue Sun, Da-Liu Min, Li-Na Tang, Ai-Na He, Yang Yao |
Journal | International journal of cancer
(Int J Cancer)
Vol. 132
Issue 2
Pg. E66-73
(Jan 15 2013)
ISSN: 1097-0215 [Electronic] United States |
PMID | 22890856
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Copyright | Copyright © 2012 UICC. |
Chemical References |
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Topics |
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Camptothecin
(administration & dosage, analogs & derivatives)
- Disease-Free Survival
- Humans
- Induction Chemotherapy
- Irinotecan
- Proportional Hazards Models
- Randomized Controlled Trials as Topic
- Stomach Neoplasms
(drug therapy, mortality, pathology)
- Treatment Outcome
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