Cochrane · systematic review · CD013700
Treatment for gastrointestinal and pancreatic neuroendocrine tumours: a network meta‐analysis
Walter, MA, Nesti, C, Spanjol, M, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Gynaecological, Neuro-oncology and Orphan CancerAMSTAR 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
43
current version
GRADE rated
35
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 8 · 18.6%Very low 19 · 44.2%Low 4 · 9.3%Moderate 9 · 20.9%High 3 · 7%
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
Estimates of effects, ranking, and certainty of evidence for different treatment options compared with placebo for disease control in pancreatic neuroendocrine tumours (pNET)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 9 Total participants: 1757 Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 9 participants | Ungraded |
Everolimus (3 RCTs; 632 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 3.29 [2.21, 4.9] | 3 studies · 632 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Everolimus + SSA (2 RCTs; 589 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 2.89 [1.61, 5.19] | 2 studies · 589 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon + SSA (2 RCTs; 171 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 2.88 [1.16, 7.13] | 2 studies · 171 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon (1 RCT; 66 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 2.58 [0.75, 8.81] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
SSA (4 RCTs, 804 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 2.36 [1.43, 3.88] | 4 studies · 804 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Surufatinib (1 RCT; 172 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 1.99 [1.02, 3.88] | 1 study · 172 participants | High |
Sunitinib (1 RCT; 171 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 1.72 [0.91, 3.27] | 1 study · 171 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Placebo (4 RCTs; 957 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 4 studies · 957 participants | Ungraded |
Dactolisib (1 RCT; 62 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 0.56 [0.13, 2.37] | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Estimates of effects, ranking, and certainty of evidence for different treatment options compared with placebo for progression‐free survival in pancreatic neuroendocrine tumours (pNET)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 10 Total participants: 2113 Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 10 participants | Ungraded |
Everolimus (3 RCT; 632 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.36 [0.28, 0.46] | 3 studies · 632 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon + SSA (2 RCTs; 468 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.34 [0.14, 0.8] | 2 studies · 468 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Everolimus + SSA (3 RCTs; 739 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.38 [0.26, 0.57] | 3 studies · 739 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Bevacizumab + SSA (1 RCT; 402 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.36 [0.15, 0.89] | 1 study · 402 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon (1 RCT; 66 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.41 [0.18, 0.94] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sunitinib (1 RCT; 171 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.42 [0.26, 0.67] | 1 study · 171 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Everolimus + bevacizumab + SSA (1 RCT; 150 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.48 [0.28, 0.83] | 1 study · 150 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Surufatinib (1 RCT; 172 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.49 [0.32, 0.76] | 1 study · 172 participants | High |
Dactolisib (1 RCT; 62 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.55 [0.25, 1.21] | 1 study · 62 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
SSA (3 RCTs; 586 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.51 [0.34, 0.77] | 3 studies · 586 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Placebo (4 RCTs; 844 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 4 studies · 844 participants | Ungraded |
Estimates of effects, ranking, and certainty of evidence for different treatment options compared with placebo for disease control in gastrointestinal neuroendocrine tumours (GI‐NET)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 11 Total participants: 1338 Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 11 participants | Ungraded |
Bevacizumab + SSA (1 RCT; 44 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 45 [3.32, 609] | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
177‐Lu‐DOTATATE + SSA (1 RCT; 229 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 30.4 [8.19, 113] | 1 study · 177 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Everolimus + SSA (1 RCT; 39 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 15.1 [2.55, 88.9] | 1 study · 39 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon + SSA (4 RCTs; 283 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 5.71 [1.9, 17.2] | 4 studies · 283 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon (2 RCTs; 86 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 4.03 [0.86, 18.8] | 2 studies · 86 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Surufatinib (1 RCT; 198 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 3.5 [1.21, 10.1] | 1 study · 198 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
SSA (7 RCTs; 796 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 2.93 [1.36, 6.32] | 7 studies · 796 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Everolimus (1 RCT; 302 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 2.53 [0.95, 6.79] | 1 study · 302 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Placebo (4 RCT; 789 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 4 studies · 789 participants | Ungraded |
Streptozocin + 5‐FU (1 RCT; 20 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | OR 0.13 [0, 4.58] | 1 study · 5 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Estimates of effects, ranking, and certainty of evidence for different treatment options compared with placebo for progression‐free survival in gastrointestinal neuroendocrine tumours (GI‐NET)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 9 Total participants: 1311Â Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 9 participants | Ungraded |
177‐Lu‐DOTATATE + SSA (1 RCT; 229 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.07 [0.02, 0.26] | 1 study · 177 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Everolimus + SSA (1 RCT; 39 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.12 [0.03, 0.54] | 1 study · 39 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Bevacizumab + SSA (2 RCTs; 446 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.18 [0.04, 0.94] | 2 studies · 446 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon + SSA (3 RCTs; 512 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.23 [0.06, 0.93] | 3 studies · 512 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Interferon (1 RCT; 66 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.27 [0.07, 1.1] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Surufatinib (1 RCT; 198 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.33 [0.12, 0.88] | 1 study · 198 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
SSA (5 RCTs; 492 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.34 [0.16, 0.76] | 5 studies · 492 participants | High |
Everolimus (1 RCT; 175 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | HR 0.56 [0.21, 1.49] | 1 study · 175 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Placebo (4 RCTs; 531 participants) Estimates of effects, ranking, and certainty of evidence for different treatment options vs placebo | no estimate extracted | 4 studies · 531 participants | Ungraded |