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Toxicity of chemotherapy regimens in advanced and metastatic pancreatic cancer therapy: A network meta‐analysis

This network meta‐analysis is adopted in order to compare the toxicity of different chemotherapy regimens in the treatment of advanced/metastatic pancreatic cancer (PC). Randomized controlled trials (RCTs) about different chemotherapy regimens for advanced/metastatic PC were included in this network...

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Published in:Journal of cellular biochemistry 2018-07, Vol.119 (7), p.5082-5103
Main Authors: Wang, Xiao‐Fang, Huang, Wen‐Feng, Nie, Jian, Zhou, Yong, Tan, Ding‐Wu, Jiang, Ji‐Hao
Format: Article
Language:English
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Summary:This network meta‐analysis is adopted in order to compare the toxicity of different chemotherapy regimens in the treatment of advanced/metastatic pancreatic cancer (PC). Randomized controlled trials (RCTs) about different chemotherapy regimens for advanced/metastatic PC were included in this network meta‐analysis using Cochrane Library and PubMed electronic databases. The network meta‐analysis was performed to combine direct and indirect evidence in order to calculate the odd ratios (OR) and draw a surface under the cumulative ranking (SUCRA) curve. A total of 19 RCTs were enrolled in this network meta‐analysis including 12 chemotherapy regimens (Gemcitabine, Gemcitabine + S‐1 [tegafur], Gemcitabine + nab‐paclitaxel, Gemcitabine + Capecitabine, Gemcitabine + Cisplatin, FOLFIRINOX [oxaliplatin + irinotecan + fluorouracil + leucovorin], Gemcitabine + oxaliplatin, Gemcitabine + irinotecan, Gemcitabine + Exatecan, Gemcitabine + pemetrexed, Gemcitabine + 5‐FU, S‐1). The incidence of anemia of Gemcitabine + Capecitabine regimen was higher compared with Gemcitabine regimen, Gemcitabine + pemetrexed regimen exhibited the highest incidence rates of anemia and neutropenia; while Gemcitabine + S‐1, Gemcitabine + Cisplatin and FOLFIRINOX regimens exhibited the highest incidence rates of neutropenia. However, S‐1 regimen exhibited lower incidence rates of leukopenia and thrombocytopenia. Moreover, the incidence rates of nausea/vomiting and rash of Gemcitabine + S‐1 regimen were higher compared with Gemcitabine regimen, while Gemcitabine + Cisplatin regimen had the highest incidence rate of nausea/vomiting. This study demonstrated that the hematologic toxicity of S‐1 regimen was the lowest, while Gemcitabine regimen exhibited the lowest incidence rate of non‐hematologic toxicity, providing guidance for the treatment of advanced/metastatic PC. This study demonstrated that the hematologic toxicity of S‐1 regimen was the lowest, while Gemcitabine regimen exhibited the lowest incidence rate of non‐hematologic toxicity, providing guidance for the treatment of advanced/metastatic PC.
ISSN:0730-2312
1097-4644
DOI:10.1002/jcb.26266