Clinical Outcomes for Previously Treated Patients with Advanced Gastric or Gastroesophageal Junction Cancer: A Systematic Literature Review and Meta-Analysis.

Autor: Abderhalden LA; MSD, Zurich, Switzerland. lauren.abderhalden@msd.com., Wu P; PRECISIONheor, Vancouver, BC, Canada., Amonkar MM; Merck & Co., Inc, Rahway, NJ, USA., Lang BM; MSD, Zurich, Switzerland., Shah S; Merck & Co., Inc, Rahway, NJ, USA., Jin F; Merck & Co., Inc, Rahway, NJ, USA., Frederickson AM; PRECISIONheor, New York, NY, USA., Mojebi A; PRECISIONheor, Vancouver, BC, Canada.
Jazyk: angličtina
Zdroj: Journal of gastrointestinal cancer [J Gastrointest Cancer] 2023 Dec; Vol. 54 (4), pp. 1031-1045. Date of Electronic Publication: 2023 May 23.
DOI: 10.1007/s12029-023-00932-5
Abstrakt: Purpose: Although second-line treatments improve survival compared to best supportive care in patients with advanced gastric cancer with disease progression on first-line therapy, prognosis remains poor. A systematic review and meta-analysis were conducted to quantify the efficacy of second-or-later line systemic therapies in this target population.
Methods: A systematic literature review (January 1, 2000 to July 6, 2021) of Embase, MEDLINE, and CENTRAL with additional searches of 2019-2021 annual ASCO and ESMO conferences was conducted to identify studies in the target population. A random-effects meta-analysis was performed among studies involving chemotherapies and targeted therapies relevant in treatment guidelines and HTA activities. Outcomes of interest were objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) presented as Kaplan-Meier data. Randomized controlled trials reporting any of the outcomes of interest were included. For OS and PFS, individual patient-level data were reconstructed from published Kaplan-Meier curves.
Results: Forty-four trials were eligible for the analysis. Pooled ORR (42 trials; 77 treatment arms; 7256 participants) was 15.0% (95% confidence interval (CI) 12.7-17.5%). Median OS from the pooled analysis (34 trials; 64 treatment arms; 60,350 person-months) was 7.9 months (95% CI 7.4-8.5). Median PFS from the pooled analysis (32 trials; 61 treatment arms; 28,860 person-months) was 3.5 months (95% CI 3.2-3.7).
Conclusion: Our study confirms poor prognosis among patients with advanced gastric cancer, following disease progression on first-line therapy. Despite the approved, recommended, and experimental systemic treatments available, there is still an unmet need for novel interventions for this indication.
(© 2023. The Author(s).)
Databáze: MEDLINE
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