TY - JOUR
T1 - Chemotherapy for Advanced Gallbladder Cancer (GBC): A Systematic Review and Meta-Analysis
AU - Azizi, Alexander A.
AU - Lamarca, Angela
AU - Mcnamara, Mairead
AU - Valle, Juan
PY - 2021/3/26
Y1 - 2021/3/26
N2 - Background: The benefit from chemotherapy, specifically for patients with gallbladder cancer (GBC), has been poorly explored since GBC is mostly studied jointly with other biliary tract cancers (BTC).
Methods: Eligible studies reporting outcome of palliative systemic chemotherapy for advanced GBC were identified through MEDLINE, cross-referencing and conferences (PROSPERO-CRD42019155745). Meta-analysis of proportions and calculation of pooled weighted means were performed.
Results: 58 eligible studies (n=1,986 patients); cisplatin/gemcitabine (33% of patients), gemcitabine/oxaliplatin (14%) or gemcitabine monotherapy (9%). Estimated pooled overall radiological response rate(ORR), and pooled weighted mean progression-free (PFS) and overall survivals (OS) were 23.2% (95%-CI 20.0-26.5) (I2: 52.5% (p<0.001)), 4.8 months (95%-CI 4.3-5.2) and 8.3 months (95%CI 7.6-8.9), respectively. Patients with non-GBC BTCs achieved a lower ORR than GBC [odds ratio 0.65 (95% CI, 0.50-0.84)].
Conclusions: GBC benefit from chemotherapy differs from other BTCs, with shorter PFS/OS despite higher ORR; new treatment options are urgently required for management of advanced GBC.
AB - Background: The benefit from chemotherapy, specifically for patients with gallbladder cancer (GBC), has been poorly explored since GBC is mostly studied jointly with other biliary tract cancers (BTC).
Methods: Eligible studies reporting outcome of palliative systemic chemotherapy for advanced GBC were identified through MEDLINE, cross-referencing and conferences (PROSPERO-CRD42019155745). Meta-analysis of proportions and calculation of pooled weighted means were performed.
Results: 58 eligible studies (n=1,986 patients); cisplatin/gemcitabine (33% of patients), gemcitabine/oxaliplatin (14%) or gemcitabine monotherapy (9%). Estimated pooled overall radiological response rate(ORR), and pooled weighted mean progression-free (PFS) and overall survivals (OS) were 23.2% (95%-CI 20.0-26.5) (I2: 52.5% (p<0.001)), 4.8 months (95%-CI 4.3-5.2) and 8.3 months (95%CI 7.6-8.9), respectively. Patients with non-GBC BTCs achieved a lower ORR than GBC [odds ratio 0.65 (95% CI, 0.50-0.84)].
Conclusions: GBC benefit from chemotherapy differs from other BTCs, with shorter PFS/OS despite higher ORR; new treatment options are urgently required for management of advanced GBC.
M3 - Article
SN - 1040-8428
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
ER -
