Meta-analysis and indirect treatment comparison of modified FOLFIRINOX and gemcitabine plus nab-paclitaxel as first-line chemotherapy in advanced pancreatic cancer.
Adult
Aged
Aged, 80 and over
Albumins
/ administration & dosage
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Deoxycytidine
/ administration & dosage
Female
Fluorouracil
/ administration & dosage
Humans
Irinotecan
/ administration & dosage
Leucovorin
/ administration & dosage
Male
Middle Aged
Neoplasm Staging
Oxaliplatin
/ administration & dosage
Paclitaxel
/ administration & dosage
Pancreatic Neoplasms
/ diagnosis
Prognosis
Publication Bias
Treatment Outcome
Gemcitabine
Gemcitabine
Modified FOLFIRINOX
Nab-paclitaxel
Network meta-analysis
Pancreatic cancer
Systematic review
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
23 Jul 2021
23 Jul 2021
Historique:
received:
01
06
2020
accepted:
16
07
2021
entrez:
24
7
2021
pubmed:
25
7
2021
medline:
21
10
2021
Statut:
epublish
Résumé
Modified FOLFIRINOX and gemcitabine plus nab-paclitaxel (GEM-NAB) have been recommended as first-line therapies for advanced pancreatic cancer (PC). Due to the lack of evidence to directly compare them, we conducted this network meta-analysis to indirectly compare the effectiveness and toxicity of modified FOLFIRINOX and GEM-NAB. The eligible retrospective studies on treatments related to modified FOLFIRINOX and GEM-NAB up to 4 April 2020 were searched and assessed. We used the frequentist model to analyze the survival and toxicity data between different treatments. Pooled analysis for overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and events of toxicity were analyzed in this study. Twenty-two studies were involved in this network meta-analysis. The comparisons on OS and PFS showed that modified FOLFIRINOX and GEM-NAB had similar treatment efficacy (OS: 1.13; 95% CI: 0.78-1.63; PFS: HR: 1.19; 95% CI: 0.85-1.67). GEM-NAB was more effective than modified FOLFIRINOX based on the result of ORR (RR: 1.43; 95% CI: 1.04-1.96). Moreover, our analysis showed a similar toxicity profile between modified FOLFIRINOX and GEM-NAB. The current evidence showed that modified FOLFIRINOX and GEM-NAB were similar in survival and toxicity. Many factors should be considered for in the formulation of optimal treatment, and our meta-analysis could provide some guidance to treatment selection in the first-line setting for advanced PC.
Sections du résumé
BACKGROUND
BACKGROUND
Modified FOLFIRINOX and gemcitabine plus nab-paclitaxel (GEM-NAB) have been recommended as first-line therapies for advanced pancreatic cancer (PC). Due to the lack of evidence to directly compare them, we conducted this network meta-analysis to indirectly compare the effectiveness and toxicity of modified FOLFIRINOX and GEM-NAB.
METHODS
METHODS
The eligible retrospective studies on treatments related to modified FOLFIRINOX and GEM-NAB up to 4 April 2020 were searched and assessed. We used the frequentist model to analyze the survival and toxicity data between different treatments. Pooled analysis for overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and events of toxicity were analyzed in this study.
RESULTS
RESULTS
Twenty-two studies were involved in this network meta-analysis. The comparisons on OS and PFS showed that modified FOLFIRINOX and GEM-NAB had similar treatment efficacy (OS: 1.13; 95% CI: 0.78-1.63; PFS: HR: 1.19; 95% CI: 0.85-1.67). GEM-NAB was more effective than modified FOLFIRINOX based on the result of ORR (RR: 1.43; 95% CI: 1.04-1.96). Moreover, our analysis showed a similar toxicity profile between modified FOLFIRINOX and GEM-NAB.
CONCLUSIONS
CONCLUSIONS
The current evidence showed that modified FOLFIRINOX and GEM-NAB were similar in survival and toxicity. Many factors should be considered for in the formulation of optimal treatment, and our meta-analysis could provide some guidance to treatment selection in the first-line setting for advanced PC.
Identifiants
pubmed: 34301232
doi: 10.1186/s12885-021-08605-x
pii: 10.1186/s12885-021-08605-x
pmc: PMC8306351
doi:
Substances chimiques
130-nm albumin-bound paclitaxel
0
Albumins
0
folfirinox
0
Oxaliplatin
04ZR38536J
Deoxycytidine
0W860991D6
Irinotecan
7673326042
Paclitaxel
P88XT4IS4D
Leucovorin
Q573I9DVLP
Fluorouracil
U3P01618RT
Gemcitabine
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
853Subventions
Organisme : National Natural Science Foundation of China
ID : 81874061
Organisme : Chinese Society of Clinical Oncology‑Shiyao Cancer Research Fund
ID : Y‑sy2019‑009
Organisme : Natural Science Foundation of Hubei Province (CN)
ID : 2018CFC846
Organisme : the 7th Wuhan Young and Middle-aged Backbone Talent of Medical Training Project 2019
ID : 2019 No. 87
Organisme : Shanghai Anticancer Association
ID : 02.01.20049
Informations de copyright
© 2021. The Author(s).
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