Third- and later-line treatment in advanced or metastatic gastric cancer: a systematic review and meta-analysis

Abstract

Aim: We performed a systematic review and meta-analysis to investigate the efficacy and safety of third-line (TLT) and salvage treatment (ST) in advanced or metastatic gastric cancer. Materials & methods: Eligible studies included randomized clinical trials assessing TLT and ST versus placebo or best supportive care. Outcomes of interest included: overall survival, objective response rate and disease control rate in TLT; progression-free survival in ST; grade 3–4 adverse events in ST. Results: The use of TLT and ST was superior to placebo or best supportive care in terms of prolonging overall survival and progression-free survival. Hematological toxicities were more frequent in ST. Conclusion: TLT and ST are considerable and tolerable treatment options for patients with advanced or metastatic gastric cancer. Given the substantial heterogeneities affecting the efficacy analyses, these results have to be interpreted cautiously.

Keywords::

• biological therapy
• chemotherapy
• gastrointestinal/colorectal
• molecular oncology
• solid tumors

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: http://www.futuremedicine.com/doi/suppl/10.2217/fon-2019-0429

Author contributions

A Rizzo has made substantial contributions to conception of the study, analyzed the data and drafted the manuscript; V Mollica has made substantial contributions to conception of the study, analyzed the data and has been involved in revising the manuscript critically for important intellectual content; AD Ricci has made substantial contributions to conception of the study and has given final approval of the version to be published; I Maggio has helped to draft and revised the manuscript; M Massucci has helped to draft and revised the manuscript; FLR Limpe revised the manuscript; F De Fabio has made substantial contributions to conception of the study and revised the manuscript; A Ardizzoni has been involved in revising the manuscript critically for important intellectual content and has given final approval of the version to be published. All authors critically revised the manuscript, approved the final version to be published and agreed to be accountable for all aspects of the work.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.