What do systematic reviews say?

Perioperative chemotherapy vs primary surgery

Perioperative chemotherapy probably leads to lower overall survival by type of data ‐ Aggregated data compared with primary surgery (moderate certainty).

• Perioperative chemo(radio)therapy versus primary surgery for resectable adenocarcinoma of the stomach,… 2013 · Cochrane Headline outcomes only
  HR 0.81 [0.72, 0.92]
  6 studies · 1373 participants
  Moderate

Chemotherapy vs gemcitabine

Various types of chemotherapy leads to lower overall survival ‐ Fixed dose rate gemcitabine compared with gemcitabine (high certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 0.79 [0.66, 0.94]
  2 studies · 644 participants
  High

Perioperative chemotherapy vs primary surgery

Perioperative chemotherapy leads to lower overall survival by type of data ‐ Individual patient data compared with primary surgery (high certainty).

• Perioperative chemo(radio)therapy versus primary surgery for resectable adenocarcinoma of the stomach,… 2013 · Cochrane Headline outcomes only
  HR 0.8 [0.66, 0.97]
  8 studies · 1049 participants
  High

Retinoic acid post‐consolidation therapy vs no further treatment

Retinoic acid postconsolidation therapy showed no clear difference in overall survival (reported as mortality) compared with no further treatment (low certainty).

• Retinoic acid postconsolidation therapy for high‐risk neuroblastoma patients treated with autologous haematopoietic… 2017 · Cochrane Headline outcomes only
  HR 0.87 [0.46, 1.63]
  1 study · 98 participants
  Low

Summary of findings 1: PLD with chemotherapy vs PLD alone

Summary of findings 3: PLD with chemotherapy showed no clear difference in overall survival (OS) compared with PLD alone (moderate certainty).

• Pegylated liposomal doxorubicin for relapsed epithelial ovarian cancer 2023 · Cochrane Headline outcomes only
  HR 0.92 [0.7, 1.21]
  1 study · 242 participants
  Moderate

Neoadjuvant immunotherapy (combined ipilimumab and nivolumab) vs neoadjuvant immunotherapy (nivolumab)

• Neoadjuvant treatment for stage III and IV cutaneous melanoma 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 23 participants
  Moderate

Gemcitabine combinations vs gemcitabine

Gemcitabine combinations may leads to lower overall survival ‐ Gemcitabine plus other combinations of chemotherapy compared with gemcitabine alone (low certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 0.55 [0.39, 0.79]
  2 studies · 166 participants
  Low

Platinum doublet vs non‐platinum therapy

Platinum doublet probably leads to lower overall survival compared with non‐platinum therapy (moderate certainty).

• Best first‐line therapy for people with advanced non‐small cell lung cancer, performance status 2 without a targetable… 2023 · Cochrane Headline outcomes only
  HR 0.67 [0.57, 0.78]
  7 studies · 697 participants
  Moderate

Exercise vs no exercise

The review found no eligible studies for this question.

• Exercise interventions for adults with cancer receiving radiation therapy alone 2023 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

ALK inhibitor vs any cytotoxic chemotherapy

ALK inhibitor leads to lower overall survival compared with any cytotoxic chemotherapy (high certainty).

• Targeted therapy for advanced anaplastic lymphoma kinase (ALK)‐rearranged non‐small cell lung cancer 2022 · Cochrane Headline outcomes only
  HR 0.84 [0.72, 0.97]
  6 studies · 1611 participants
  High

Single‐immune checkpoint inhibitors (ICIs) vs chemotherapy alone

Single‐immune checkpoint inhibitors (ICIs) probably leads to lower overall survival (OS) compared with chemotherapy (moderate certainty).

• Single or combined immune checkpoint inhibitors compared to first‐line platinum‐based chemotherapy with or without… 2021 · Cochrane Headline outcomes only
  HR 0.68 [0.6, 0.76]
  6 studies · 2111 participants
  Moderate

Combined immune checkpoint inhibitors (ICIs) vs chemotherapy alone

Combined immune checkpoint inhibitors (ICIs) probably leads to lower overall Survival (OS) compared with chemotherapy (moderate certainty).

• Single or combined immune checkpoint inhibitors compared to first‐line platinum‐based chemotherapy with or without… 2021 · Cochrane Headline outcomes only
  HR 0.72 [0.59, 0.89]
  2 studies · 612 participants
  Moderate

Taxane followed by anthracyclines vs anthracyclines followed by taxane

Taxane followed by anthracyclines showed no clear difference in overall survival ( compared with anthracyclines followed by taxane (moderate certainty).

• Sequencing of anthracyclines and taxanes in neoadjuvant and adjuvant therapy for early breast cancer 2019 · Cochrane Headline outcomes only
  HR 0.8 [0.6, 1.08]
  2 studies · 947 participants
  Moderate

Taxane followed by anthracyclines vs anthracyclines followed by taxane

The review found no eligible studies for this question.

• Sequencing of anthracyclines and taxanes in neoadjuvant and adjuvant therapy for early breast cancer 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Bethanechol vs Artificial saliva

Bethanechol showed no clear difference in overall survival compared with artificial saliva; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  40 weeks postRT
  RR 1.59 [0.43, 5.84]
  1 study · 43 participants
  GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Palifermin showed no clear difference in overall survival compared with placebo (moderate certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  42 to 72 months from baseline
  HR 1.00 [0.72, 1.39]
  3 studies
  Moderate

Amifostine (intravenous) vs Amifostine (subcutaneous)

Amifostine (intravenous) showed no clear difference in overall survival compared with amifostine (subcutaneous); GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  48 months postRT
  HR 1.36 [0.89, 2.10]
  1 study
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes overall survival compared with no treatment/placebo (very low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  Up to and including 6 months postRT
  RR 1.07 [0.80, 1.43]
  1 study · 60 participants
  Very low

Chinese medicine vs no treatment/placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  12 months postRT
  Insufficient evidence to determine any effect on overall survival (Hu 2005; Analysis 6.4)
  1 study
  GRADE not reported

Amifostine vs no treatment/placebo

It is very uncertain whether amifostine changes overall survival compared with no treatment/placebo (very low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  12 to 24 months postRT
  HR 1.18 [0.85, 1.66]
  2 studies · 271 participants
  Very low