Meta Analysis of Oxaliplatin-based Combination Chemotherapy for Advanced Gallbladder and Bile Duct Cancers (AGBC)

Thatikonda, Chandana; Miller, Austin; Iyer, Renuka

doi:10.14309/00000434-201010001-00194

Cited by 1 publication

(1 citation statement)

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“…However, this finding should be interpreted with caution, given the retrospective nature of the study and the inclusion of triple therapies involving gemcitabine-cisplatin within the other chemotherapy group. As the range of potential combination therapies expands, including gemcitabine paired with other platinum agents such as oxaliplatin [ 12 , 39 ] and carboplatin [ 40 , 41 ] or with targeted agents such as erlotinib [ 12 ], high-quality, prospective, comparative trials similar to the ABC-02 trial are needed for assessment of the relative efficacy of different treatments.…”

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confidence: 99%

Gemcitabine Plus Cisplatin for Advanced Biliary Tract Cancer: A Systematic Review

Park

Hsu

et al. 2015

Cancer Res Treat

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Evidence suggests that combined gemcitabine-cisplatin chemotherapy extends survival in patients with advanced biliary tract cancer (BTC). We conducted a systematic review in order to collate this evidence and assess whether gemcitabine-cisplatin efficacy is influenced by primary tumor site, disease stage, or geographic region, and whether associated toxicities are related to regimen. MEDLINE (1946-search date), EMBASE (1966-search date), ClinicalTrials. gov (2008-search date), and abstracts from major oncology conferences (2009- search date) were searched (5 Dec 2013) using terms for BTC, gemcitabine, and cisplatin. All study types reporting efficacy (survival, response rates) or safety (toxicities) outcomes of gemcitabine-cisplatin in BTC were eligible for inclusion; efficacy data were extracted from prospective studies only. Evidence retrieved from one meta-analysis (abstract), four randomized controlled trials, 12 nonrandomized prospective studies, and three retrospective studies supported the efficacy and safety of gemcitabine-cisplatin for BTC. Median overall survival ranged from 4.6 to 11.7 months, and response rate ranged from 17.1% to 36.6%. Toxicities were generally acceptable and manageable. Heterogeneity in study designs and data collected prevented formal meta-analysis, however exploratory assessments suggested that efficacy did not vary with primary tumor site (gallbladder vs. others), disease stage (metastatic vs. locally advanced), or geographic origin (Asia vs. other). Incidence of grade 3/4 toxicities was not related to gemcitabine dose or cisplatin frequency. Despite individual variation in study designs, the evidence presented suggests that gemcitabine-cisplatin is effective in patients from a diverse range of countries and with heterogeneous disease characteristics. No substantial differences in toxicity were observed among the different dosing schedules of gemcitabine and cisplatin.

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