Overall survival benefits for irinotecan-containing regimens as first-line treatment for advanced gastric cancer: An updated meta-analysis of 10 randomized controlled trials
International Journal of Cancer, 08/17/2012
Qi W-X et al. – This updated meta-analysis provided strong evidence for a survival benefit of irinotecan-containing regimen as first line treatment for advanced gastric cancer. A clear advantage of irinotecan-containing over non irinotecan-containing regimen had not been established.Methods
- 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 1837 patients from 10 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 [PFS: HR0.82, 95%CI: 0.69-0.97, p=0.026), though the improvement of time to failure (TTF: 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 (ORR: RR 1.16, 95%CI 0.91-1.49, P=0.24]was 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.