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Capecitabine, 5-fluorouracil and S-1 based regimens for previously untreated advanced oesophagogastric cancer: A network meta-analysis

ter Veer, E., Ngai, L. L., van Valkenhoef, G., Mohammad, N. H., Anderegg, M. C. J., van Oijen, M. G. H. & van Laarhoven, H. W. M. 2-Aug-2017 In : Scientific Reports. 7, 8 p., 7142

Research output: Scientific - peer-reviewArticle

  • Emil ter Veer
  • Lok Lam Ngai
  • Gert van Valkenhoef
  • Nadia Haj Mohammad
  • Maarten C. J. Anderegg
  • Martijn G. H. van Oijen
  • Hanneke W. M. van Laarhoven

As evidence is inconsistent and based on either isolated Asian or Western studies, we conducted a network meta-analysis (NMA) to examine efficacy and safety of 5-FU (5-fluorouracil), capecitabine and S-1-based first-line treatment of advanced esophagogastric cancer in Asian and Western patients. Medline, EMBASE, CENTRAL and conferences ASCO and ESMO were searched up to January 2016 for randomized-controlled-trials comparing 5-FU, capecitabine or S-1-based regimens with equal chemotherapy backbones. Direct and indirect data for overall survival (OS) and progression-free-survival (PFS) were combined on the Hazard Ratio (HR)-scale using random-effects NMA and calculated as combined HRs and 95% credible intervals (95% CrI). Grade 1-2 and grade 3-4 adverse events were compared with pair-wise meta-analysis. Fifteen studies were identified including capecitabine (n = 945), 5-FU (n = 2,132) or S-1 (n = 1,636). No differences were found in respectively OS and PFS for capecitabine-based versus 5-FU-based regimens (HR = 0.89, 95% CrI = 0.76-1.04 and HR = 0.98, 95% CrI = 0.75-1.32), S-1-based versus 5-FU-based regimens (HR = 0.92, 95% CrI = 0.82-1.04 and HR = 0.88, 95% CrI = 0.70-1.11) and S-1-based versus capecitabine-based regimens (HR = 1.03, 95% CrI = 0.87-1.22 and HR = 0.89, 95% CrI = 0.65-1.20). Effects were similar in Asian and Western subgroups. Toxicity profiles were different but a lower frequency of relevant adverse events was observed with S-1 In conclusion, as efficacy was similar, choosing fluoropyrimidines should be based on their individual toxicity profiles.

Original languageEnglish
Article number7142
Number of pages8
JournalScientific Reports
Volume7
StatePublished - 2-Aug-2017

    Keywords

  • ADVANCED GASTRIC-CANCER, RANDOMIZED PHASE-III, COMBINATION CHEMOTHERAPY, 1ST-LINE TREATMENT, TRIAL, ADENOCARCINOMA, FLUOROURACIL, OXALIPLATIN, PACLITAXEL, GUIDELINES

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