Cochrane · systematic review · CD012078
Salvage systemic therapy for advanced gastric and oesophago‐gastric junction adenocarcinoma
Tomita, Y, Moldovan, M, Chang Lee, R, et al. · Cochrane Database of Systematic Reviews · 2020 · 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
34
current version
GRADE rated
34
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 5 · 14.7%Low 13 · 38.2%Moderate 9 · 26.5%High 7 · 20.6%
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
Chemotherapy versus placebo, best supportive care (BSC) or no treatment
Population: advanced gastric and oesophago‐gastric junction adenocarcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Chemotherapy vs placebo, best supportive care (BSC) or no treatment | HR 0.66 [0.52, 0.83] | 2 studies · 547 participants | Moderate Downgraded: imprecision |
Progression‐free survival Chemotherapy vs placebo, best supportive care (BSC) or no treatment | HR 0.57 [0.47, 0.69] | 1 study · 507 participants | High |
Serious adverse events Chemotherapy vs placebo, best supportive care (BSC) or no treatment | RR 1.38 [1.2, 1.59] | 1 study · 503 participants | Moderate Downgraded: imprecision |
Tumour response rate Chemotherapy vs placebo, best supportive care (BSC) or no treatment | RR 2.17 [0.63, 7.48] | 1 study · 435 participants | Low Downgraded: imprecision |
Any adverse events Chemotherapy vs placebo, best supportive care (BSC) or no treatment | RR 1.04 [1, 1.09] | 1 study · 503 participants | High |
Biological therapy versus placebo, best supportive care (BSC) or no treatment
Population: advanced gastric and oesophago‐gastric junction adenocarcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Biological therapy vs placebo, best supportive care (BSC) or no treatment | HR 0.55 [0.41, 0.73] | 3 studies · 781 participants | High |
Progression‐free survival Biological therapy vs placebo, best supportive care (BSC) or no treatment | HR 0.33 [0.19, 0.57] | 3 studies · 781 participants | Moderate Downgraded: inconsistency |
Serious adverse events Biological therapy vs placebo, best supportive care (BSC) or no treatment | RR 1.14 [0.95, 1.37] | 2 studies · 638 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Tumour response rate Biological therapy vs placebo, best supportive care (BSC) or no treatment | RR 5.12 [1.23, 21.27] | 3 studies · 687 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Any adverse events Biological therapy vs placebo, best supportive care (BSC) or no treatment | RR 1.08 [1, 1.17] | 1 study · 491 participants | High |
Quality of life (QoL Biological therapy vs placebo, best supportive care (BSC) or no treatment | no estimate extracted | 2 studies · 283 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Chemotherapy versus biological therapy
Population: advanced gastric and oesophago‐gastric junction adenocarcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Chemotherapy vs biological therapy | HR 0.82 [0.66, 1.02] | 1 study · 395 participants | Moderate Downgraded: imprecision |
Progression‐free survival Chemotherapy vs biological therapy | HR 1.27 [1.03, 1.57] | 1 study · 395 participants | Moderate Downgraded: risk of bias, imprecision |
Serious adverse events Chemotherapy vs biological therapy | RR 0.41 [0.3, 0.57] | 1 study · 570 participants | Low Downgraded: risk of bias, imprecision |
Tumour response rate Chemotherapy vs biological therapy | RR 1.17 [0.72, 1.88] | 1 study · 395 participants | Low Downgraded: risk of bias, imprecision |
Any adverse events Chemotherapy vs biological therapy | RR 0.63 [0.56, 0.71] | 1 study · 570 participants | Moderate Downgraded: risk of bias, imprecision |
Chemmotherapy combined with biological therapy versus chemotherapy
Population: advanced gastric and oesophago‐gastric junction adenocarcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Chemmotherapy combined with biological therapy vs chemotherapy | HR 0.93 [0.83, 1.04] | 7 studies · 2743 participants | Moderate Downgraded: risk of bias |
Progression‐free survival Chemmotherapy combined with biological therapy vs chemotherapy | HR 0.87 [0.74, 1.02] | 7 studies · 2743 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Serious adverse events Chemmotherapy combined with biological therapy vs chemotherapy | RR 1.17 [0.95, 1.44] | 4 studies · 1618 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Tumour response rate Chemmotherapy combined with biological therapy vs chemotherapy | RR 1.35 [0.99, 1.85] | 6 studies · 2404 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Any adverse events Chemmotherapy combined with biological therapy vs chemotherapy | RR 1.01 [1, 1.03] | 3 studies · 1513 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life (QoL) Chemmotherapy combined with biological therapy vs chemotherapy | HR 0.88 [0.74, 1.04] | 2 studies · 1154 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Chemotherapy versus chemotherapy
Population: advanced gastric adenocarcinoma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (non‐taxane monotherapy vs taxane monotherapy) Chemotherapy vs chemotherapy | HR 1.13 [0.86, 1.48] | 1 study · 219 participants | Low Downgraded: imprecision |
Overall survival (taxane‐containing doublet therapy vs taxane monotherapy) Chemotherapy vs chemotherapy | HR 1.05 [0.72, 1.54] | 2 studies · 121 participants | Low Downgraded: risk of bias, imprecision |
Overall survival (non‐taxane containing therapy vs another non‐taxane containing therapy) Chemotherapy vs chemotherapy | no estimate extracted | 1 study · 107 participants | High |
Progression‐free survival (non‐taxane monotherapy vs taxane monotherapy) Chemotherapy vs chemotherapy | HR 1.14 [0.88, 1.48] | 1 study · 219 participants | Low Downgraded: imprecision |
Progression‐free survival (taxane‐containing doublet therapy vs taxane monotherapy) Chemotherapy vs chemotherapy | HR 0.75 [0.52, 1.09] | 2 studies · 121 participants | Low Downgraded: risk of bias, imprecision |
Progression‐free survival (non‐taxane containing therapy vs another non‐taxane containing therapy) Chemotherapy vs chemotherapy | no estimate extracted | 1 study · 107 participants | High |
Serious adverse effects Chemotherapy vs chemotherapy | no estimate extracted | 4 studies · 448 participants | High |
Tumour response rate (non‐taxane monotherapy vs taxane monotherapy) Chemotherapy vs chemotherapy | RR 0.65 [0.34, 1.26] | 1 study · 179 participants | Low Downgraded: risk of bias, imprecision |
Tumour response rate (taxane‐containing doublet therapy vs taxane monotherapy) Chemotherapy vs chemotherapy | RR 1.47 [0.56, 3.89] | 2 studies · 121 participants | Very low Downgraded: risk of bias, imprecision |
Tumour response rate (non‐taxane containing therapy vs another non‐taxane containing therapy) Chemotherapy vs chemotherapy | RR 0.89 [0.48, 1.67] | 1 study · 107 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Chemotherapy vs chemotherapy | no estimate extracted | 4 studies · 448 participants | Moderate Downgraded: risk of bias, imprecision |
Quality of life Chemotherapy vs chemotherapy | no estimate extracted | 1 study · 70 participants | Very low Downgraded: risk of bias, imprecision |