What do systematic reviews say?

Chemotherapy vs gemcitabine

Various types of chemotherapy probably leads to lower overall survival ‐ FOLFIRINOX compared with gemcitabine (moderate certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 0.51 [0.43, 0.6]
  2 studies · 652 participants
  Moderate

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 biological therapy

Chemotherapy probably leads to higher progression‐free survival compared with biological therapy (moderate certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 1.27 [1.03, 1.57]
  1 study · 395 participants
  Moderate

Chemotherapy vs biological therapy

Chemotherapy may leads to lower serious adverse events compared with biological therapy (low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 0.41 [0.3, 0.57]
  1 study · 570 participants
  Low

Chemotherapy vs biological therapy

Chemotherapy showed no clear difference in tumour response rate compared with biological therapy (low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 1.17 [0.72, 1.88]
  1 study · 395 participants
  Low

Chemotherapy vs biological therapy

Chemotherapy probably leads to lower any adverse events compared with biological therapy (moderate certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 0.63 [0.56, 0.71]
  1 study · 570 participants
  Moderate

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

Chemotherapy leads to lower progression‐free survival compared with placebo, best supportive care (BSC) or no treatment (high certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 0.57 [0.47, 0.69]
  1 study · 507 participants
  High

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

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

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

Chemotherapy vs chemotherapy alone

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

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 1.14 [0.88, 1.48]
  1 study · 219 participants
  Low
• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 0.75 [0.52, 1.09]
  2 studies · 121 participants
  Low
• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 107 participants
  High

Chemotherapy vs chemotherapy alone

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 448 participants
  High

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

Chemotherapy probably leads to higher serious adverse events 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
  RR 1.38 [1.2, 1.59]
  1 study · 503 participants
  Moderate

Chemotherapy vs chemotherapy alone

Chemotherapy showed no clear difference in tumour response rate (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
  RR 0.65 [0.34, 1.26]
  1 study · 179 participants
  Low
• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 0.89 [0.48, 1.67]
  1 study · 107 participants
  Low

Chemotherapy vs chemotherapy alone

It is very uncertain whether chemotherapy changes tumour response rate (taxane‐containing doublet therapy vs taxane… compared with chemotherapy (very low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 1.47 [0.56, 3.89]
  2 studies · 121 participants
  Very low

Chemotherapy vs chemotherapy alone

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 448 participants
  Moderate

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 · 70 participants
  Very low

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

Chemotherapy showed no clear difference in tumour response rate compared with placebo, best supportive care (BSC) or no treatment (low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 2.17 [0.63, 7.48]
  1 study · 435 participants
  Low

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

Chemotherapy showed no clear difference in any adverse events compared with placebo, best supportive care (BSC) or no treatment (high certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  RR 1.04 [1, 1.09]
  1 study · 503 participants
  High