1. Meta-analysis and indirect treatment comparison of modified FOLFIRINOX and gemcitabine plus nab-paclitaxel as first-line chemotherapy in advanced pancreatic cancer.
- Author
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Chen, Jiayuan, Hua, Qingling, Wang, Haihong, Zhang, Dejun, Zhao, Lei, Yu, Dandan, Pi, Guoliang, Zhang, Tao, and Lin, Zhenyu
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PANCREATIC cancer , *OVERALL survival , *PROGRESSION-free survival , *SURVIVAL analysis (Biometry) , *TREATMENT effectiveness , *CANCER chemotherapy , *GEMCITABINE , *THERAPEUTIC use of antineoplastic agents , *PANCREATIC tumors , *PUBLICATION bias , *ALBUMINS , *FOLINIC acid , *RESEARCH , *META-analysis , *RESEARCH methodology , *PROGNOSIS , *ANTINEOPLASTIC agents , *DEOXYCYTIDINE , *MEDICAL cooperation , *EVALUATION research , *FLUOROURACIL , *TUMOR classification , *COMPARATIVE studies , *RESEARCH funding , *PACLITAXEL - Abstract
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: 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: 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: 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. [ABSTRACT FROM AUTHOR]- Published
- 2021
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