What do systematic reviews say?

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 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 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 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

Chemotherapy vs best supportive care

Chemotherapy probably leads to lower overall survival compared with best supportive care (moderate certainty).

• Chemotherapy for advanced gastric cancer 2017 · Cochrane Headline outcomes only
  HR 0.37 [0.24, 0.55]
  3 studies · 184 participants
  Moderate

Chemotherapy vs best supportive care

Chemotherapy probably leads to lower time to progression compared with best supportive care (moderate certainty).

• Chemotherapy for advanced gastric cancer 2017 · Cochrane Headline outcomes only
  HR 0.31 [0.22, 0.43]
  2 studies · 144 participants
  Moderate

Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC

Summary of findings table (subcomparison 1): chemotherapy or… leads to lower overall survival compared with BSC (high certainty).

• Palliative chemotherapy and targeted therapies for esophageal and gastroesophageal junction cancer 2017 · Cochrane Headline outcomes only
  HR 0.81 [0.71, 0.92]
  5 studies · 750 participants
  High

Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC

It is very uncertain whether summary of findings table (subcomparison 1): chemotherapy or… changes progression‐free survival compared with BSC (very low certainty).

• Palliative chemotherapy and targeted therapies for esophageal and gastroesophageal junction cancer 2017 · Cochrane Headline outcomes only
  HR 0.58 [0.28, 1.18]
  2 studies · 540 participants
  Very low

Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC

It is very uncertain whether summary of findings table (subcomparison 1): chemotherapy or… changes toxicity compared with BSC (very low certainty).

• Palliative chemotherapy and targeted therapies for esophageal and gastroesophageal junction cancer 2017 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 972 participants
  Very low

Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC

• Palliative chemotherapy and targeted therapies for esophageal and gastroesophageal junction cancer 2017 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 1129 participants
  Very low

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

Biological therapy 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 1.08 [1, 1.17]
  1 study · 491 participants
  High

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

• Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 283 participants
  Low

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

Anti‐cancer therapy vs best supportive care

Anti‐cancer therapy showed no clear difference in overall survival compared with best supportive care (moderate certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 1.08 [0.88, 1.33]
  4 studies · 298 participants
  Moderate