What do systematic reviews say?

Chemmotherapy combined with biological therapy vs chemotherapy alone

Chemmotherapy combined with biological therapy showed no clear difference in quality of life (QoL) compared with chemotherapy (low certainty).

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  HR 0.88 [0.74, 1.04]
  2 studies · 1154 participants
  Low

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

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

Biological therapy leads to lower overall 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 0.55 [0.41, 0.73]
  3 studies · 781 participants
  High

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

Biological therapy probably leads to lower progression‐free 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 0.33 [0.19, 0.57]
  3 studies · 781 participants
  Moderate

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

Biological therapy showed no clear difference in serious adverse events 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 1.14 [0.95, 1.37]
  2 studies · 638 participants
  Low

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

Biological therapy may leads to higher 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 5.12 [1.23, 21.27]
  3 studies · 687 participants
  Low

Intervention not reported

The intervention showed no clear difference in postoperative mortality (moderate certainty).

• Pylorus‐preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical… 2016 · Cochrane Headline outcomes only
  OR 0.64 [0.26, 1.54]
  7 studies · 464 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in pancreatic fistula (low certainty).

• Pylorus‐preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical… 2016 · Cochrane Headline outcomes only
  OR 0.95 [0.49, 1.84]
  7 studies · 468 participants
  Low

Intervention not reported

The intervention may leads to higher DGE (low certainty).

• Pylorus‐preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical… 2016 · Cochrane Headline outcomes only
  OR 3.03 [1.05, 8.7]
  7 studies · 459 participants
  Low