Findings

What do systematic reviews say?

1,476 questions · 1,535 findings · 101 reviews

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No studies found 233 · 15.2%GRADE not reported 332 · 21.6%Very low 209 · 13.6%Low 343 · 22.3%Moderate 279 · 18.2%High 139 · 9.1%

BRAF inhibitors vs chemotherapy alone

Tumour response · people with cutaneous melanoma

BRAF inhibitors leads to higher tumour response compared with chemotherapy (high certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
RR 6.78 [4.84, 9.49]
925 participants
High

Anti‐PD1 monoclonal antibodies vs chemotherapy alone

Progression‐free survival · people with cutaneous melanoma

Anti‐PD1 monoclonal antibodies probably leads to lower progression‐free survival† compared with chemotherapy (moderate certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
HR 0.49 [0.39, 0.61]
957 participants
Moderate

BRAF inhibitors vs chemotherapy alone

Toxicity (≥ G3) · people with cutaneous melanoma

BRAF inhibitors showed no clear difference in toxicity (≥ G3) compared with chemotherapy (low certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
RR 1.27 [0.48, 3.33]
408 participants
Low

MEK inhibitors vs chemotherapy alone

Overall survival† · people with cutaneous melanoma

MEK inhibitors showed no clear difference in overall survival† compared with chemotherapy (low certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
HR 0.85 [0.58, 1.25]
496 participants
Low

MEK inhibitors vs chemotherapy alone

Progression‐free survival · people with cutaneous melanoma

MEK inhibitors probably leads to lower progression‐free survival† compared with chemotherapy (moderate certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
HR 0.58 [0.42, 0.8]
496 participants
Moderate

MEK inhibitors vs chemotherapy alone

Tumour response · people with cutaneous melanoma

MEK inhibitors leads to higher tumour response compared with chemotherapy (high certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
RR 2.01 [1.35, 2.99]
496 participants
High

MEK inhibitors vs chemotherapy alone

Toxicity (≥ G3) · people with cutaneous melanoma

MEK inhibitors probably leads to higher toxicity (≥ G3) compared with chemotherapy (moderate certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
RR 1.61 [1.08, 2.41]
91 participants
Moderate

Anti‐PD1 monoclonal antibodies vs chemotherapy alone

Tumour response · people with cutaneous melanoma

Anti‐PD1 monoclonal antibodies leads to higher tumour response compared with chemotherapy (high certainty).

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
RR 3.42 [2.38, 4.92]
1367 participants
High

Anti‐PD1 monoclonal antibodies vs chemotherapy alone

Toxicity (≥ G3) · people with cutaneous melanoma

1 finding from 1 review

Systemic treatments for metastatic cutaneous melanoma 2018 · Cochrane Headline outcomes only
0.55 [0.31, 0.97]
1360 participants
Low

Intestinal trefoil factor (ITF), oral spray vs placebo

Oral mucositis (moderate to severe) · Adults receiving chemotherapy alone for colorectal cancer

Intestinal trefoil factor (ITF), oral spray led to lower oral mucositis (moderate to severe) compared with placebo; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RR 0.22 [0.10, 0.48]
1 study · 99 participants
GRADE not reported

Bethanechol vs Artificial saliva

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol showed no clear difference in xerostomia (dry mouth, yes/no) compared with artificial saliva; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
8 to 40 weeks postRT
RR 0.56 [0.30, 1.05]
1 study · 30 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.63 [0.30, 1.29]
1 study · 36 participants
GRADE not reported

Polaprezinc vs Azulene oral rinse

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on salivary flow rates were reported.
0 studies
No studies found

Bethanechol vs Artificial saliva

Salivary flow rate (unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol led to higher salivary flow rate (unstimulated, ml/min) compared with artificial saliva; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
MD 0.12 [0.01, 0.23]
1 study · 36 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
8 to 40 weeks postRT
MD 0.07 [-0.02, 0.16]
1 study · 33 participants
GRADE not reported

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

Progression‐free survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Palifermin showed no clear difference in progression-free survival compared with placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
42 to 72 months from baseline
HR 1.06 [0.80, 1.42]
3 studies
GRADE not reported

Bethanechol vs Artificial saliva

Overall survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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

1 finding from 1 review

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

Amifostine vs no treatment/placebo

Dysphagia (grade >= 3, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine showed no clear difference in dysphagia (grade >= 3, 0-4 scale) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; up to 3 months postRT
RR 0.50 [0.17, 1.48]
2 studies · 73 participants
GRADE not reported

Polaprezinc vs Azulene oral rinse

Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on adverse events were reported.
0 studies
No studies found

Polaprezinc vs Azulene oral rinse

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Tumour response by RECIST criteria reported for a specific group of patients only; no usable survival data (Watanabe 2010)
1 study
GRADE not reported

Chinese medicine vs no treatment/placebo

Salivary flow rate (stimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Chinese medicine led to higher salivary flow rate (stimulated) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
MD 0.09 [0.03, 0.15]
1 study · 50 participants
GRADE not reported

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

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Palifermin showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.97 [0.77, 1.22]
3 studies · 471 participants
Low