Increased Risk of High-Grade Hemorrhage in Cancer Patients Treated with Gemcitabine: A Meta-Analysis of 20 Randomized Controlled Trials: e74872

• Published in: PloS one 2013-09, Vol.8 (9)
• Main Authors: Hu, Yi, Wang, Jingliang, Tao, Haitao, Wu, Baishou, Sun, Jin, Cheng, Yao, Dong, Weiwei, Li, Ruixin
• Format: Article
• Language: English
• Subjects: Chemotherapy
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0074872

Purpose Gemcitabine, a third-generation anticancer agent, has been shown to be active in several solid tumors. High-grade hemorrhage (grade greater than or equal to 3) has been reported with this drug, although the overall risk remains unclear. We conducted a meta-analysis of randomized controlled trials evaluating the incidence and risk of high-grade hemorrhage associated with gemcitabine. Methods Pubmed was searched for articles published from January 1, 1990 to December 31, 2012. Eligible studies included prospective randomized controlled phase II and III trials evaluating gemcitabine-based vs non-gemcitabine-based therapy in patients with solid tumors. Data on high-grade hemorrhage were extracted. Overall incidence rates, relative risk (RR), and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of included trials. Results A total of 6433 patients from 20 trials were included. Among patients treated with gemcitabine-based chemotherapy, the overall incidence of high-grade hemorrhage was 1.7% (95%CI: 0.9-3.1%), and the RR of high-grade hemorrhage was 2.727 (95%CI: 1.581-4.702, p