The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis
Background: Although gemcitabine plus cisplatin (GP) is considered as standard chemotherapy for patients with advanced biliary tract cancer (BTC), the optimal regimen remains unknown.Methods: Using Network meta-analysis (NMA), a systematic review was conducted to find the most effective chemotherapy...
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doaj-b06c5a5240684876adb78410bf50b9952020-11-24T21:31:46ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-05-01910.3389/fonc.2019.00441455693The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-AnalysisYan Li0Yan Li1Yaoyao Zhou2Yonglan Hong3Meizhi He4Shuyi Wei5Chen Yang6Dayong Zheng7Dayong Zheng8Feiye Liu9Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaThe First School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaIntegrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, ChinaThe First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaIntegrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, ChinaBackground: Although gemcitabine plus cisplatin (GP) is considered as standard chemotherapy for patients with advanced biliary tract cancer (BTC), the optimal regimen remains unknown.Methods: Using Network meta-analysis (NMA), a systematic review was conducted to find the most effective chemotherapy regimen for advanced BTC. We searched PubMed, Web of Science, Embase, Scopus and the Cochrane Library for articles published before October 6, 2018. Articles about chemotherapeutic comparisons were included. Hazard ratios (HRs) for overall survival (OS) and progression free survival (PFS) were estimated while odd ratios (ORs) was assessed for objective response rate (ORR).Results: The NMA included 25 studies and 3,312 individuals. Among all the regimens, Folfox-4 regimen obtained a superior difference in OS (BSC vs. Folfox-4, HR 3.4, 95% CI 1.7-6.7). XP was slightly better than GP in OS and GS approximately obtained the same efficacy to GP (HR for XP vs. GP 0.74, 95% CI 0.51-1.1; HR for GS vs. GP 1.1, 95% CI 0.71-1.5). Most of the targeted therapies included in this study tend to achieve better results in PFS and ORR but failed to improve OS, in which E-GEMOX achieved the best ORR when compared to BSC (OR 0.03, 95% CI 0.00-0.94).Conclusions: Folfox-4 regimen is likely to be the optimal chemotherapy for patients with advanced BTC and the predominant targeted therapy hasn't achieved significant success currently. XP and GS can be considered as alternatives for advanced BTC.https://www.frontiersin.org/article/10.3389/fonc.2019.00441/fullbiliary tract cancerchemotherapyFolfox-4network meta-analysisefficacy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yan Li Yan Li Yaoyao Zhou Yonglan Hong Meizhi He Shuyi Wei Chen Yang Dayong Zheng Dayong Zheng Feiye Liu |
spellingShingle |
Yan Li Yan Li Yaoyao Zhou Yonglan Hong Meizhi He Shuyi Wei Chen Yang Dayong Zheng Dayong Zheng Feiye Liu The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis Frontiers in Oncology biliary tract cancer chemotherapy Folfox-4 network meta-analysis efficacy |
author_facet |
Yan Li Yan Li Yaoyao Zhou Yonglan Hong Meizhi He Shuyi Wei Chen Yang Dayong Zheng Dayong Zheng Feiye Liu |
author_sort |
Yan Li |
title |
The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis |
title_short |
The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis |
title_full |
The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis |
title_fullStr |
The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis |
title_full_unstemmed |
The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis |
title_sort |
efficacy of different chemotherapy regimens for advanced biliary tract cancer: a systematic review and network meta-analysis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2019-05-01 |
description |
Background: Although gemcitabine plus cisplatin (GP) is considered as standard chemotherapy for patients with advanced biliary tract cancer (BTC), the optimal regimen remains unknown.Methods: Using Network meta-analysis (NMA), a systematic review was conducted to find the most effective chemotherapy regimen for advanced BTC. We searched PubMed, Web of Science, Embase, Scopus and the Cochrane Library for articles published before October 6, 2018. Articles about chemotherapeutic comparisons were included. Hazard ratios (HRs) for overall survival (OS) and progression free survival (PFS) were estimated while odd ratios (ORs) was assessed for objective response rate (ORR).Results: The NMA included 25 studies and 3,312 individuals. Among all the regimens, Folfox-4 regimen obtained a superior difference in OS (BSC vs. Folfox-4, HR 3.4, 95% CI 1.7-6.7). XP was slightly better than GP in OS and GS approximately obtained the same efficacy to GP (HR for XP vs. GP 0.74, 95% CI 0.51-1.1; HR for GS vs. GP 1.1, 95% CI 0.71-1.5). Most of the targeted therapies included in this study tend to achieve better results in PFS and ORR but failed to improve OS, in which E-GEMOX achieved the best ORR when compared to BSC (OR 0.03, 95% CI 0.00-0.94).Conclusions: Folfox-4 regimen is likely to be the optimal chemotherapy for patients with advanced BTC and the predominant targeted therapy hasn't achieved significant success currently. XP and GS can be considered as alternatives for advanced BTC. |
topic |
biliary tract cancer chemotherapy Folfox-4 network meta-analysis efficacy |
url |
https://www.frontiersin.org/article/10.3389/fonc.2019.00441/full |
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