Systemic oncological treatments in patients with advanced pancreatic cancer: a scoping review and evidence map

Abstract

Purpose To identify, describe, and organise currently available evidence regarding systemic oncological treatments (SOTs) (chemotherapy, targeted/biological therapies, and immunotherapy) compared to best supportive care (BSC) for patients with advanced pancreatic cancer (PC). Methods We conducted a scoping review and evidence mapping, adhering to PRISMA-ScR checklist. We searched MEDLINE, EMBASE, Cochrane Library, Epistemonikos, PROSPERO, and clinicaltrials.gov for eligible studies. We included systematic reviews (SRs), randomised controlled trials (RCTs), quasi-experimental, and observational studies evaluating SOTs compared to BSC or no treatment in patients with advanced PC. Two independent reviewers performed the screening process and data extraction. We developed evidence maps as an interactive visualization display, including the assessed interventions and outcomes. Results Of the 50,601 records obtained from our search, we included 43 studies: 2 SRs, 16 RCTs, 4 quasi-experimental studies, 20 observational studies, and 1 protocol for a quasi-experimental study. Forty-two studies reported survival-related outcomes and most favoured SOTs, while five reported toxicity and most favoured BSC. Other patient-centred outcomes, such as quality of life, were scarcely reported. Conclusions This study highlights the current evidence gaps in studies assessing treatments for patients with advanced PC, mainly the lack of reports of non-survival-related outcomes, pointing out research areas that need further attention to make better recommendations for these patients.

Treatment with anticancer drugs for advanced pancreatic cancer: a systematic review

“…Through the previous stages of our broad evidence synthesis project [ 14 ], we identified 43 studies, with 59 references, that included participants with advanced PC and were included in our scoping review and evidence map. We identified 337 additional references through our search update.…”

“…This study is the last part of a three-stage comprehensive evidence synthesis project (ASTAC project) [ 16 ]. Briefly, we first conducted an overview of SRs [ 13 ] and then a scoping review and evidence map of primary and secondary studies assessing the effectiveness of TAD versus SC/no treatment for advanced PC [ 14 ].…”

“…However, through previous stages of our broad evidence synthesis project [ 13 ] we found that previous systematic reviews (SRs) that compared TAD with supportive care (SC) or no treatment in patients with advanced PC did not find conclusive evidence to support one option over the other. Moreover, we found that there were relevant primary studies that were not included in those SRs [ 14 ]. Therefore, we think it is still reasonable to compare TADs with SC or no treatment to assess the trade-off of clinical benefits and possible harms and in consequence, we aimed to conduct a new SR, following strict methodological guidelines, to assess the efficacy of TAD versus SC or no treatment in people with advanced PC, considering all patient-important outcomes.…”

Vasohibin-2-Targeting Therapies for the Treatment of Pancreatic Ductal Adenocarcinoma

“…Moreover, recurrence is common, even after successful surgery (Schepis et al 2023). Although the incorporation of combined cytotoxic chemotherapy regimens has substantially improved outcomes, the overall 5-year survival rate of PDAC is still less than 10%, and there is an urgent need for the development of effective treatments worldwide (Salazar et al 2023).…”

“…Molecular targeting therapy is a promising option for the treatment of various cancers. Although numerous efforts have been made to establish effective molecular targeted therapies for PDAC, their efficacy is limited (Salazar et al 2023). Because most PDAC contain mutant KRAS (Halbrook et al 2023), the recent development of KRAS inhibitors has offered considerable hope for the treatment of PDACs.…”