Cochrane · systematic review · CD004063
Palliative chemotherapy and targeted therapies for esophageal and gastroesophageal junction cancer
Janmaat, VT, Steyerberg, EW, van der Gaast, A, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
33
current version
GRADE rated
29
No studies
1
Included studies
NR
No studies 1 · 3%Ungraded 3 · 9.1%Very low 18 · 54.5%Low 1 · 3%Moderate 5 · 15.2%High 5 · 15.2%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table: chemotherapy or targeted therapy agent(s) plus control intervention versus control intervention alone for palliative treatment of esophageal and GE‐junction carcinoma
Population: palliative participants with esophageal and GE‐junction carcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table: chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.75 [0.68, 0.84] | 11 studies · 1347 participants | High |
Progression‐free survival Summary of findings table: chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.64 [0.45, 0.92] | 5 studies · 883 participants | Moderate Downgraded: inconsistency |
Toxicity Summary of findings table: chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 9 studies · 3296 participants | Very low Downgraded: imprecision, inconsistency |
Quality of life Summary of findings table: chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 5 studies · 1870 participants | Very low |
Summary of findings table (sensitivity analysis): interventions esophageal and GE‐junction carcinoma versus gastric carcinoma
Population: palliative participants with esophageal and GE‐junction carcinoma or gastric carcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Studies with gastric cancer participants in addition to eligible participants Summary of findings table (sensitivity analysis): interventions esophageal and GE‐junction carcinoma vs gastric carcinoma | HR 0.94 [0.83, 1.05] | 8 studies · 1755 participants | Ungraded |
Sensitivity analysis, meta‐regression analysis, first part Summary of findings table (sensitivity analysis): interventions esophageal and GE‐junction carcinoma vs gastric carcinoma | HR 0.75 [0.68, 0.84] | 11 studies · 1347 participants | Very low Downgraded: inconsistency, indirectness |
Sensitivity analysis, only esophageal and GE‐junction cancer participants Summary of findings table (sensitivity analysis): interventions esophageal and GE‐junction carcinoma vs gastric carcinoma | HR 0.66 [0.54, 0.81] | 5 studies · 538 participants | Ungraded |
Sensitivity analysis, only gastric cancer participants Summary of findings table (sensitivity analysis): interventions esophageal and GE‐junction carcinoma vs gastric carcinoma | HR 0.89 [0.76, 1.04] | 5 studies · 2093 participants | Ungraded |
Sensitivity analysis, meta‐regression analysis, second part Summary of findings table (sensitivity analysis): interventions esophageal and GE‐junction carcinoma vs gastric carcinoma | HR 0.66 [0.54, 0.81] | 5 studies · 538 participants | Moderate Downgraded: imprecision, inconsistency |
Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) versus BSC for palliative treatment of esophageal and GE‐junction carcinoma
Population: palliative participants with esophageal and GE‐junction carcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC | HR 0.81 [0.71, 0.92] | 5 studies · 750 participants | High |
Progression‐free survival Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC | HR 0.58 [0.28, 1.18] | 2 studies · 540 participants | Very low Downgraded: imprecision, inconsistency |
Toxicity Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC | no estimate extracted | 3 studies · 972 participants | Very low |
Quality of life Summary of findings table (subcomparison 1): chemotherapy or targeted therapy plus best supportive care (BSC) vs BSC | no estimate extracted | 4 studies · 1129 participants | Very low |
Summary of findings table (subcomparison 2): second‐line chemotherapy or targeted therapy agent(s) plus control intervention versus control intervention alone for palliative treatment of esophageal and GE‐junction carcinoma
Population: palliative participants with esophageal and GE‐junction carcinoma previously treated with chemotherapy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table (subcomparison 2): second‐line chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.71 [0.54, 0.94] | 4 studies · 769 participants | Moderate Downgraded: imprecision, inconsistency |
Progression‐free survival Summary of findings table (subcomparison 2): second‐line chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.51 [0.29, 0.9] | 3 studies · 677 participants | Low Downgraded: imprecision, inconsistency |
Toxicity Summary of findings table (subcomparison 2): second‐line chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 4 studies · 1638 participants | Very low |
Quality of life Summary of findings table (subcomparison 2): second‐line chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 4 studies · 1638 participants | Very low |
Summary of findings table (subcomparison 3): chemotherapy agent(s) plus control intervention versus control intervention alone for palliative treatment of esophageal and GE‐junction carcinoma
Population: palliative participants with esophageal and GE‐junction carcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table (subcomparison 3): chemotherapy agent(s) plus control intervention vs control intervention alone | HR 0.73 [0.63, 0.85] | 5 studies · 358 participants | Moderate Downgraded: imprecision |
Progression‐free survival Summary of findings table (subcomparison 3): chemotherapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | NR | No studies |
Toxicity Summary of findings table (subcomparison 3): chemotherapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 4 studies · 1638 participants | Very low |
Quality of life Summary of findings table (subcomparison 3): chemotherapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 450 participants | Very low |
Summary of findings table (subcomparison 4): targeted therapy agent plus control intervention versus control intervention alone for palliative treatment of esophageal and GE‐junction carcinoma
Population: palliative participants with esophageal and GE‐junction carcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table (subcomparison 4): targeted therapy agent plus control intervention vs control intervention alone | HR 0.75 [0.63, 0.9] | 6 studies · 989 participants | High |
Progression‐free survival Summary of findings table (subcomparison 4): targeted therapy agent plus control intervention vs control intervention alone | HR 0.64 [0.45, 0.92] | 5 studies · 883 participants | Moderate Downgraded: inconsistency |
Toxicity Summary of findings table (subcomparison 4): targeted therapy agent plus control intervention vs control intervention alone | no estimate extracted | 6 studies · 3020 participants | Very low |
Quality of life Summary of findings table (subcomparison 4): targeted therapy agent plus control intervention vs control intervention alone | no estimate extracted | 4 studies · 2054 participants | Very low |
Summary of findings table (subcomparison 5): chemotherapy or targeted therapy agent(s) plus control intervention versus control intervention alone in participants with AC of the esophagus
Population: palliative participants with AC of the esophagus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table (subcomparison 5): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.66 [0.54, 0.81] | 5 studies · 538 participants | High |
Progression‐free survival Summary of findings table (subcomparison 5): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.62 [0.38, 1] | 4 studies · 713 participants | Very low Downgraded: imprecision, inconsistency |
Toxicity Summary of findings table (subcomparison 5): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 5 studies · 2676 participants | Very low |
Quality of life Summary of findings table (subcomparison 5): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 4 studies · 1772 participants | Very low |
Summary of findings table (subcomparison 6): chemotherapy or targeted therapy agent(s) plus control intervention versus control intervention alone in participants with SCC of the esophagus
Population: palliative participants with SCC of the esophagus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table (subcomparison 6): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.76 [0.65, 0.9] | 4 studies · 268 participants | High |
Progression‐free survival Summary of findings table (subcomparison 6): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | HR 0.72 [0.55, 0.96] | 2 studies · 168 participants | Very low Downgraded: risk of bias, imprecision |
Toxicity Summary of findings table (subcomparison 6): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 2 studies · 150 participants | Very low |
Quality of life Summary of findings table (subcomparison 6): chemotherapy or targeted therapy agent(s) plus control intervention vs control intervention alone | no estimate extracted | 1 study · 156 participants | Very low |