What do systematic reviews say?

Chemotherapy vs placebo, best supportive care (BSC) or no treatment

Chemotherapy probably leads to lower overall survival compared with placebo, best supportive care (BSC) or no treatment (moderate certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 0.66 [0.52, 0.83]
  2 studies · 547 participants
  Moderate

Chemotherapy vs biological therapy

Chemotherapy showed no clear difference in overall survival compared with biological therapy (moderate certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 0.82 [0.66, 1.02]
  1 study · 395 participants
  Moderate

Chemotherapy vs best supportive care

Chemotherapy probably leads to lower overall survival compared with best supportive care (moderate certainty).

• Chemotherapy for advanced gastric cancer 2017 · Cochrane Headline outcomes only
  HR 0.37 [0.24, 0.55]
  3 studies · 184 participants
  Moderate

Chemotherapy vs chemotherapy alone

Chemotherapy showed no clear difference in overall survival (non‐taxane monotherapy vs taxane monotherapy) compared with chemotherapy (low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 1.13 [0.86, 1.48]
  1 study · 219 participants
  Low

Post‐surgical chemotherapy vs surgery

Post‐surgical chemotherapy leads to lower overall Survival (OS) compared with surgery alone (high certainty).

• Post‐surgical chemotherapy versus surgery alone for resectable gastric cancer 2013 · Cochrane Headline outcomes only
  HR 0.85 [0.8, 0.9]
  34 studies · 7523 participants
  High

Chemotherapy vs chemotherapy alone

Chemotherapy showed no clear difference in overall survival (taxane‐containing doublet therapy vs taxane… compared with chemotherapy (low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 1.05 [0.72, 1.54]
  2 studies · 121 participants
  Low

Summary of findings: Molecular‐targeted therapy plus chemotherapy vs chemotherapy alone

Summary of findings: Molecular‐targeted therapy plus chemotherapy showed no clear difference in overall survival compared with chemotherapy alone (low certainty).

• Molecular‐targeted first‐line therapy for advanced gastric cancer 2016 · Cochrane Headline outcomes only
  HR 0.92 [0.8, 1.05]
  10 studies · 3843 participants
  Low

Chemotherapy vs chemotherapy alone

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 107 participants
  High