Chemotherapy vs supportive care alone for relapsed gastric, gastroesophageal junction, and oesophageal adenocarcinoma: a meta-analysis of patient-level data.

摘要: Second-line chemotherapy treatment of patients with relapsed gastric and oesophageal cancers in comparison supportive care (SC) alone has been supported by recent phase 3 clinical trials, but a meta-analysis patient-level data is lacking. We searched Medline, the Cochrane Central Register Controlled Trials (CENTRAL), Web Science for trials that compared second-line SC cancers. A comprehensive from three identified was performed. total 410 (n=301), gastroesophageal junction (n=76), or (n=33) adenocarcinoma were identified. In all, 154 received single-agent docetaxel 84 irinotecan, each SC. given to 172 patients. Chemotherapy significantly reduced risk death (hazard ratio (HR)=0.63, 95% confidence interval (CI)=0.51–0.77, P<0.0001). This effect observed (HR=0.71, CI=0.56–0.89, P=0.003) irinotecan (HR=0.49, CI=0.36–0.67, P<0.001). Overall survival (OS) benefit greatest who progressed 3–6 months following first-line (HR=0.39, CI=0.26–0.59, Performance status (PS) 0–1 PS 2 (HR=0.66, CI=0.46–0.94, P=0.02), locally advanced disease metastatic (HR=0.41, CI=0.25–0.67, P=0.0004) older age (HR=0.94 per 5 years, CI=0.90–0.99, P=0.01) significant predictors improved OS. Progression during (HR=1.24, CI=0.96–1.59) within first completion (HR=1.42, CI=1.09–1.83) an increased progression between 6 (P=0.03). Health-related quality life outcomes reported only one precluding these parameters. confirms results better OS platinum fluoropyrimidine refractory oesphageal adenocarcinoma. should be included future this setting.