Network meta-analysis of effcacy and safety of chemotherapy and target therapy in the first-line setting of advanced pancreatic cancer

Kun I. Lin, Jia Lian Yang, Yu Chao Lin, Che Yi Chou, Jin Hua Chen, Chin Chuan Hung

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Both gemcitabine and fluoropyrimidine are recommended backbones in the first-line treatment of pancreatic ductal adenocarcinoma (PDAC). To compare the efficacy and safety of these two therapeutic backbones, and to investigate the optimal therapies, we conducted a network meta-analysis. By retrospective analysis of randomized controlled trials (RCT), the most preferred therapeutic regimen may be predicted. The eligible RCTs of the gemcitabine-based therapies and fluoropyrimidine-based therapies were searched up to 31 August 2019. In a frequentist network meta-analysis, treatments were compared and ranked according to overall survival (OS) and progression-free survival (PFS). Thirty-two trials with 10,729 patients were included. The network meta-analyses results for overall survival and progression-free survival showed that fluoropyrimidine-based therapy seems to be the most effective treatment choice. Compared to gemcitabine combined with taxanes or immunotherapy, fluoropyrimidine-based therapy had comparable treatment effects (PFS: 0.67, p-Value = 0.11; 0.76, p-Value = 0.32; OS: 0.80, p-Value = 0.16; 0.77, p-Value = 0.21). Moreover, the combination of immunotherapy and gemcitabine had tolerable toxicities. Based on current evidence, fluoropyrimidine-based therapies and the combination of gemcitabine and taxanes were the most effective therapies in the advanced pancreatic cancer, and the combination of immunotherapy and gemcitabine can be developed into a new form of therapy.

Original languageEnglish
Article number1746
JournalCancers
Volume11
Issue number11
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Advanced pancreatic cancer
  • Adverse effects
  • Chemotherapy
  • Effcacy outcomes
  • Target therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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