Cited by 1,171Gastric Cancer Management and OutcomesColorectal Cancer Treatments and StudiesIntraperitoneal and Appendiceal Malignancies

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Chemotherapy in Advanced Gastric Cancer: A Systematic Review and Meta-Analysis Based on Aggregate Data

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Wagner, Anna D., Grothe, Wilfried, Haerting, Johannes, Kleber, Gerhard, Grothey, Axel, Fleig, Wolfgang E.·2006·Journal of Clinical Oncology

DOI 10.1200/jco.2005.05.0245

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Abstract

Purpose: This systematic review and meta-analysis were performed to assess the efficacy and tolerability of chemotherapy in patients with advanced gastric cancer. Methods: Randomized phase II and III clinical trials on first-line chemotherapy in advanced gastric cancer were identified by electronic searches of Medline, Embase, the Cochrane Controlled Trials Register, and Cancerlit; hand searches of relevant abstract books and reference lists; and contact to experts. Meta-analysis was performed using the fixed-effect model. Overall survival, reported as hazard ratio (HR) with 95% CI, was the primary outcome measure. Results: Analysis of chemotherapy versus best supportive care (HR = 0.39; 95% CI, 0.28 to 0.52) and combination versus single agent, mainly fluorouracil (FU) -based chemotherapy (HR = 0.83; 95% CI = 0.74 to 0.93) showed significant overall survival benefits in favor of chemotherapy and combination chemotherapy, respectively. In addition, comparisons of FU/cisplatin-containing regimens with versus without anthracyclines (HR = 0.77; 95% CI, 0.62 to 0.95) and FU/anthracycline-containing combinations with versus without cisplatin (HR = 0.83; 95% CI, 0.76 to 0.91) both demonstrated a significant survival benefit for the three-drug combination. Comparing irinotecan-containing versus nonirinotecan-containing combinations (mainly FU/cisplatin) resulted in a nonsignificant survival benefit in favor of the irinotecan-containing regimens (HR = 0.88; 95% CI, 0.73 to 1.06), but they have never been compared against a three-drug combination. Conclusion: Best survival results are achieved with three-drug regimens containing FU, an anthracycline, and cisplatin. Among these, regimens including FU as bolus exhibit a higher rate of toxic deaths than regimens using a continuous infusion of FU, such as epirubicin, cisplatin, and continuous-infusion FU.

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Background
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Background
Clinical impact of the HGF/MET pathway activation in patients with advanced gastric cancer treated with palliative chemotherapy
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Background
Expression of taxol resistance gene 1 correlates with gastric cancer patient clinical outcome and induces taxol resistance
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Result
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Background
A randomised phase II trial of capecitabine plus cisplatin versus S-1 plus cisplatin as a first-line treatment for advanced gastric cancer: Capecitabine plus cisplatin ascertainment versus S-1 plus cisplatin randomised PII trial (XParTS II)
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Background
14-3-3σ attenuates RhoGDI2-induced cisplatin resistance through activation of Erk and p38 in gastric cancer cells
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BackgroundResultInfluential
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Background
Prognostic Significance of Serum Levels of Vascular Endothelial Growth Factor and Insulin-Like Growth Factor-1 in Advanced Gastric Cancer Patients Treated with FOLFOX Chemotherapy
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FS-7 inhibits MGC-803 cells growth in vitro and in vivo via down-regulating glycolysis
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“Here, PPI analysis indicated that several key genes of TRX showed anti-tumor effects in the treatment of GC.”
BackgroundInfluential
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Authors: Wagner, A. D., Grothe, W., Haerting, J., Kleber, G., Grothey, A., & Fleig, W. E.
Affiliations: From the First Department of Medicine, Coordinating Centre for Clinical Trials, Department of Medicine IV, and Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany; and Mayo Clinic College of Medicine, Rochester, MN
Mayo Clinic (US)
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2006-06-20
Volume: 24
Issue: 18
Pages: 2903-2909
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2005.05.0245
OpenAlex: W2145390243
Cited by: 1,171
References: 51
Citations by year: 2026: 7 · 2025: 15 · 2024: 26 · 2023: 28 · 2022: 34 · 2021: 64 · 2020: 55 · 2019: 54 · 2018: 69 · 2017: 89 · 2016: 72 · 2015: 84 · 2014: 105 · 2013: 92 · 2012: 77
FWCI: 9.54
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Funders: American Society of Clinical Oncology
Bundesministerium für Bildung und Forschung (01GH0105)
Topics: Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
Health Sciences › Medicine › Surgery › Intraperitoneal and Appendiceal Malignancies
Keywords: advanced gastric cancer, first-line chemotherapy, 5-fluorouracil, cisplatin, anthracyclines, irinotecan, combination chemotherapy, overall survival, best supportive care, epirubicin, chemotherapy toxicity
MeSH terms: Antineoplastic Combined Chemotherapy Protocols, Humans, Stomach Neoplasms

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Chemotherapy in Advanced Gastric Cancer: A Systematic Review and Meta-Analysis Based on Aggregate Data

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