Cisplatin/gemcitabine or oxaliplatin/gemcitabine in the treatment of advanced biliary tract cancer: a systematic review

Cancer Medicine

Frédéric Fiteni¹  Thierry Nguyen¹  Dewi Vernerey³  Marie-Justine Paillard¹  Stefano Kim¹  Martin Demarchi¹  Francine Fein²  Christophe Borg¹  Franck Bonnetain³ 

[1] Department of Medical Oncology, University Hospital of Besançon, Besançon, France;Department of Gastroenterology, University Hospital of Besançon, Besançon, France;Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France

关键词: Biliary tract cancer;    cisplatin;    gemcitabine;    oxaliplatin;   

DOI  :  10.1002/cam4.299

来源: Wiley

【 摘 要 】

Abstract

Cisplatin/gemcitabine association has been a standard of care for first-line regimen in advanced biliary tract cancer nevertheless oxaliplatin/gemcitabine regimen is frequently preferred. Because comparative effectiveness in clinical outcomes of cisplatin- versus oxaliplatin-containing chemotherapy is not available, a systematic review of studies assessing cisplatin/gemcitabine or oxaliplatin/gemcitabine chemotherapies in advanced biliary tract cancer was performed. Published studies evaluating cisplatin/gemcitabine or oxaliplatin/gemcitabine in advanced biliary tract cancer were included. Each study was weighted according to the number of patients included. The primary objective was to assess weighted median of medians overall survival (mOS) reported for both regimens. Secondary goals were to assess weighted median of medians progression-free survival (mPFS) and toxic effects were pooled and compared within each arm. Thirty-three studies involving 1470 patients were analyzed. In total, 771 and 699 patients were treated by cisplatin/gemcitabine and oxaliplatin/gemcitabine, respectively. Weighted median of mOS was 9.7 months in cisplatin group and 9.5 months in oxaliplatin group. Cisplatin-based chemotherapy was significantly associated with more grade 3 and 4 asthenia, diarrhea, liver toxicity, and hematological toxicity. Sensitivity analysis including only the studies with the standard regimen of cisplatin (25–35 mg/m² administered on days 1 and 8) showed that the weighted median of mOS increased from 9.7 to 11.7 months but Gem/CDDP regimen remained more toxic than Gemox regimen. These results suggest that the Gem/CDDP regimen with cisplatin (25–35 mg/m²) administered on days 1 and 8 is associated with survival advantage than Gemox regimen but with addition of toxicity.

【 授权许可】

CC BY   
© 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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