GEMCITABINE FOR BILIARY TRACT CANCER

Anticancer Drugs. 2013 Jun 24. [Epub ahead of print]

Efficacy of gemcitabine plus platinum agents for biliary tract cancers: a meta-analysis.

Yang R, Wang B, Chen YJ, Li HB, Hu JB, Zou SQ.

Source

Department of General Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Abstract

The objective of this study was to carry out a meta-analysis of the efficacy of gemcitabine+platinum agent regimens in the treatment of advanced biliary tract cancer (BTC). PubMed and Google Scholar were searched using the following combination of search terms: gemcitabine, oxaliplatin, cholangiocarcinoma, biliary, gallbladder, bile duct. Studies were eligible for inclusion in the meta-analysis if they were randomized trials on the use of gemcitabine plus a platinum agent for the treatment of advanced (unresectable or metastatic cancer) BTC. Outcomes of interest were response rate, overall survival, and progression-free survival. Pooled odds ratios/differences in median survival and 95% confidence intervals (CIs) were determined for each outcome. A total of 47 records were identified in the initial search. Ultimately, three open-label randomized trials (two phase 2 and one phase 3) met the eligibility criteria and were included in the meta-analysis. Two studies compared gemcitabine plus cisplatin with gemcitabine alone, whereas the other study compared gemcitabine plus oxaliplatin with fluorouracil-folinic acid. The total number of patients in the studies ranged from 54 to 410. The overall analyses revealed that all survival outcomes assessed were significantly more favorable for patients treated with gemcitabine plus platinum agents than for patients not treated with this combination. Response rates: odds ratio=2.639, 95% CI=1.210-5.757, Z=2.439, P=0.015; pooled difference in median overall survival=3.822 months, 95% CI=1.798-5.845 months, Z=3.702, P<0 .001="" 95="" advanced="" agents="" are="" better="" btc="" chemotherapy.="" ci="1.996-4.541" combination="" compared="" difference="" experience="" gemcitabine="" in="" may="" median="" months="" not="" of="" outcomes="" p="" patients="" platinum="" plus="" pooled="" progression-free="" survival="" this="" treated="" who="" with="" z="5.035,">