Adjuvant treatment for resected pancreatic adenocarcinoma: A systematic review and network meta-analysis

被引：17

作者：

Parmar, Ambica ^{[1
]}

Chaves-Porras, Jorge ^{[1
]}

Saluja, Ronak ^{[1
]}

Perry, Kaitlyn ^{[1
]}

Rahmadian, Amanda P. ^{[1
]}

Delos Santos, Seanthel ^{[1
]}

Ko, Yoo-Joung ^{[1
]}

Berry, Scott ^{[2
]}

Doherty, Mark ^{[1
]}

Chan, Kelvin K. W. ^{[1
,3
]}

机构：

[1] Sunnybrook Hlth Sci Ctr, Odette Canc Ctr, 2075 Bayview Ave,Room T2-058, Toronto, ON M4N 3M5, Canada

[2] Queens Univ, Kingston Hlth Sci Ctr, Kingston, ON, Canada

[3] Canadian Ctr Appl Res Canc Control, Toronto, ON, Canada

来源：

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY | 2020年 / 145卷

关键词：

Pancreatic neoplasms; Chemotherapy; Adjuvant; Systematic review; Network meta-analysis; Survival; ISPOR TASK-FORCE; PHASE-III TRIAL; FOLINIC ACID; OPEN-LABEL; CANCER; CHEMOTHERAPY; GEMCITABINE; THERAPY; CHEMORADIOTHERAPY; 5-FLUOROURACIL;

D O I：

10.1016/j.critrevonc.2019.102817

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Adjuvant chemotherapy has significantly improved outcomes following surgical resection for pancreatic adenocarcinoma; however, the optimal adjuvant strategy remains unclear. This systematic review and network meta-analysis was conducted to provide indirect comparative evidence across adjuvant chemotherapies. Electronic searches of EMBASE, MEDLINE, Cochrane and ASCO databases were conducted to identify eligible randomized controlled trials (RCT). Direct pairwise meta-analysis was conducted for disease-free survival (DFS), overall-survival (OS) and adverse events (AE). Network meta-analysis of DFS and OS was conducted to evaluate indirect comparisons. Ten publications of eleven RCT met eligibility criteria. Indirect DFS comparison demonstrated superiority of mFOLFIRINOX versus gemcitabine-capecitabine, gemcitabine-erlotinib and gemcitabine-nab-paclitaxel. S-1 demonstrated a DFS benefit versus gemcitabine-capecitabine, gemcitabine-erlotinib, gemcitabine-nab-paclitaxel. OS benefits were demonstrated for mFOLFIRINOX verus gemcitabine-erlotinib and for S-1 versus gemcitabine-based combination with erlotinib, capecitabine and nab-paclitaxel. In conclusion, mFOLFIRINOX is the preferred approach for adjuvant therapy. For mFOLFIRINOX-ineligible patients no additional benefit is seen with gemcitabine-nab-paclitaxel.

引用

页数：9

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