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Carolina Requeijo,1,* Javier Bracchiglione,1– 3,* Nicolás Meza,2 Roberto Acosta-Dighero,2 Josefina Salazar,1 Marilina Santero,1 Adriana-G Meade,1 María Jesús Quintana,1,3,4 Gerardo Rodríguez-Grijalva,1 Anna Selva,3,5 Ivan Solà,1,3 Gerard Urrútia,1,3 Xavier Bonfill Cosp1,3,4 On behalf of Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC) Research Group1Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; 2Interdisciplinary Centre for Health Studies (CIESAL), Valparaiso University, Viña del Mar, Chile; 3CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; 4Autonomous University of Barcelona, Barcelona, Spain; 5Clinical Epidemiology and Cancer Screening, Parc Taulí Hospital Universitari, Parc Taulí Research and Innovation Institute Foundation (I3PT-CERCA), Autonomous University of Barcelona, Sabadell, Spain*These authors contributed equally to this workCorrespondence: Carolina Requeijo, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni M. Claret 167. Pavelló 18 planta 0. 08025, Barcelona, Spain, Email crequeijo@santpau.catIntroduction: Despite being commonly recommended, the impact of anticancer drugs (ACDs) on patient-important outcomes beyond survival for advanced hepatobiliary cancers (HBCs) may not have been sufficiently assessed. We aim to identify and map the evidence regarding ACDs versus best supportive care (BSC) for advanced HBCs, considering patient-centered outcomes.Methods: In this mapping review, we included systematic reviews, randomized controlled trials, quasi-experimental, and observational studies comparing ACDs (chemotherapy, immunotherapy, biological/targeted therapy) versus BSC for advanced HBCs. We searched MEDLINE (PubMed), EMBASE (Ovid), Cochrane Library, Epistemonikos, PROSPERO and clinicaltrials.gov for eligible studies. Two reviewers performed the screening and data extraction processes. We developed evidence maps for each type of cancer.Results: We included 87 studies (60 for advanced liver cancer and 27 for gallbladder or bile duct cancers). Most of the evidence favored ACDs for survival outcomes, and BSC for toxicity. We identified several evidence gaps for non-survival outcomes, including quality of life or quality of end-of-life care.Discussion: Patient-important outcomes beyond survival in advanced HBCs are insufficiently assessed by the available evidence. Future studies need to address these gaps to better inform decision-making processes.Keywords: liver neoplasms, gallbladder neoplasms, bile duct neoplasms, antineoplastic agents, immunotherapy, biological therapy, palliative care |
