Li ZH, Ma YJ, Jia ZH, Weng YY, Zhang P, Zhu SJ, Wang F. Meta-analysis of gemcitabine plus nab-paclitaxel combined with targeted agents in the treatment of metastatic pancreatic cancer. World J Clin Cases 2022; 10(27): 9703-9713 [PMID: 36186177 DOI: 10.12998/wjcc.v10.i27.9703]
Corresponding Author of This Article
Fang Wang, MD, Chief Doctor, Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, No. 6 Huajiadi Road, Beijing 100102, China. wf074500@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhong-Hui Li, Yin-Jie Ma, Shi-Jie Zhu, Fang Wang, Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
Zong-Hang Jia, Department of Oncology, Shandong University of Traditional Chinese Medicine, Jinan 250022, Shandong Province, China
Yue-Yan Weng, Department of Acupuncture and Moxibustion, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
Ping Zhang, Department of Pathology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
Author contributions: Li ZH performed literature search, collected the data, statistical analysis and wrote the manuscript; Ma YJ designed the study, performed literature search, collected the data, performed statistical analysis and wrote the manuscript; Li ZH and Ma YJ have contributed equally to this work; Jia ZH performed statistical analysis, revised the manuscript and provided critical opinion; Weng YY analyzed and interpreted the data; Zhang P, Wang F, and Zhu SJ provided critical opinion and revised the manuscript; Wang F provided critical opinion, participated in literature search, and revised the manuscript; Li ZH and Ma YJ have contributed equally to this work. all authors approved the final manuscript.
Conflict-of-interest statement: The authors declare that there is no potential conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Wang, MD, Chief Doctor, Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, No. 6 Huajiadi Road, Beijing 100102, China. wf074500@163.com
Received: April 3, 2022 Peer-review started: April 3, 2022 First decision: May 11, 2022 Revised: May 17, 2022 Accepted: August 15, 2022 Article in press: August 15, 2022 Published online: September 26, 2022
Abstract
BACKGROUND
Gemcitabine plus nab-paclitaxel (GA) is a commonly used first-line treatment regimen for metastatic pancreatic cancer, and many studies will add a novel targeted agent to this regimen for improving patient survival rate. However, the clinical effectiveness of GA is the most controversial issue.
AIM
To compare the efficacy and safety of GA regimen with a targeted agent and GA regimen.
METHODS
Up to 1 December 2021, the eligible randomized controlled trials (RCTs) relating to GA and GA with a targeted agent were searched on PubMed, EMBASE and Cochrane Library for eligible data. We screened out appropriate studies for overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and toxicity, which had been pooled and finally analyzed by using Stata version 15.1. In addition, we use Reference Citation Analysis (https://www.referencecitationanalysis.com/) to collect the latest related literature to improve the latest cutting-edge research results.
RESULTS
Seven RCTs involving 1544 patients (848 men and 696 women) were included. There were no significant differences between GA with a targeted agent and GA in PFS [hazard ratio (HR): 1.18 95% confidence interval (CI): 0.91-1.53], OS (HR: 1.12 95%CI: 0.99-1.27), and ORR (HR: 0.96 95%CI: 0.71-1.29). There was no notable difference in the two groups in grade 3/4 toxicity (fatigue, anemia, vomiting and neutropenia), whereas the incidence of grade 3/4 diarrhea considerably increased in GA with a targeted drug.
CONCLUSION
Adding a novel targeted agent to the GA regimen did not improve survival rate of patients with metastatic pancreatic cancer.
Core Tip: Gemcitabine plus nab-paclitaxel (GA) is a commonly used first-line treatment regimen for metastatic pancreatic cancer, and many studies will add a novel targeted agent to this regimen to improve patient survival. However, the clinical effectiveness of GA is more controversial. We conducted a meta-analysis to compare the effectiveness and safety of GA combined with a targeted agent regimen and GA regimen.
