What do systematic reviews say?

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

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

Perioperative chemotherapy vs primary surgery

Perioperative chemotherapy leads to lower overall survival by chemo‐/radiotherapy ‐ Chemotherapy only 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 0.83 [0.75, 0.91]
  10 studies · 2033 participants
  High

Perioperative chemotherapy vs primary surgery

Perioperative chemotherapy probably leads to lower overall survival by chemo‐/radiotherapy ‐ Chemoradiotherapy 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 0.7 [0.5, 0.99]
  4 studies · 389 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 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 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

Concomitant (concurrent) chemoradiotherapy vs chemoradiotherapy plus surgery

Chemoradiotherapy showed no clear difference in overall survival compared with chemoradiotherapy plus surgery (high certainty).

• Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer 2017 · Cochrane Headline outcomes only
  HR 0.99 [0.79, 1.24]
  2 studies · 431 participants
  High

Concomitant (concurrent) chemoradiotherapy vs chemoradiotherapy plus surgery

Chemoradiotherapy probably leads to lower freedom from locoregional relapse compared with chemoradiotherapy plus surgery (moderate certainty).

• Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer 2017 · Cochrane Headline outcomes only
  HR 0.55 [0.39, 0.76]
  2 studies · 431 participants
  Moderate

Concomitant (concurrent) chemoradiotherapy vs chemoradiotherapy plus surgery

• Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 165 participants
  Very low

Concomitant (concurrent) chemoradiotherapy vs chemoradiotherapy plus surgery

Chemoradiotherapy may leads to higher treatment‐related mortality compared with chemoradiotherapy plus surgery (low certainty).

• Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer 2017 · Cochrane Headline outcomes only
  RR 5.11 [1.74, 15.02]
  2 studies · 431 participants
  Low