Evidence map›Paper›PMID 27722826›Full record

SynthesisGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2017

A Bayesian network meta-analysis on second-line systemic therapy in advanced gastric cancer.

Xiaofu Zhu, Yoo-Joung Ko, Scott Berry, Keya Shah, Esther Lee, Kelvin Chan

Open access · bronzeAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Xiaofu ZhuCross Cancer Institute, Edmonton , AB, T6G 1Z2, Canada.
Yoo-Joung KoSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, M4N 3M5, Canada.
Scott BerrySunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, M4N 3M5, Canada.
Keya ShahSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, M4N 3M5, Canada.
Esther LeeSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, M4N 3M5, Canada.
Kelvin ChanSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, M4N 3M5, Canada. kelvin.chan@sunnybrook.ca.
University of Toronto · CASunnybrook Health Science Centre · CAGreen Cross International · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is unclear which regimen is the most efficacious among the available therapies for advanced gastric cancer in the second-line setting. We performed a network meta-analysis to determine their relative benefits.

methodsWe conducted a systematic review of randomized controlled trials (RCTs) through the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases and American Society of Clinical Oncology abstracts up to June 2014 to identify phase III RCTs on advanced gastric cancer in the second-line setting. Overall survival (OS) data were the primary outcome of interest. Hazard ratios (HRs) were extracted from the publications on the basis of reported values or were extracted from survival curves by established methods. A Bayesian network meta-analysis was performed with WinBUGS to compare all regimens simultaneously.

resultsEight RCTs (2439 patients) were identified and contained extractable data for quantitative analysis. Network meta-analysis showed that paclitaxel plus ramucirumab was superior to single-agent ramucirumab [OS HR 0.51, 95 % credible region (CR) 0.30-0.86], paclitaxel (OS HR 0.81, 95 % CR 0.68-0.96), docetaxel (OS HR 0.56, 95 % CR 0.33-0.94), and irinotecan (OS HR 0.71, 95 % CR 0.52-0.99). Paclitaxel plus ramucirumab also had an 89 % probability of being the best regimen among all these regimens. Single-agent ramucirumab, paclitaxel, docetaxel, and irinotecan were comparable to each other with respect to OS and were superior to best supportive care.

conclusionsThis is the first network meta-analysis to compare all second-line regimens reported in phase III gastric cancer trials. The results suggest the paclitaxel plus ramucirumab combination is the most effective therapy and should be the reference regimen for future comparative trials.

Indexed as

Antineoplastic AgentsSalvage TherapyStomach NeoplasmsBayes TheoremHumansRandomized Controlled Trials as TopicAntineoplastic AgentsGastric cancerNetwork meta-analysisSecond-line therapySystemic therapy

Identifiers

PMID27722826
OpenAlexW2528470522

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.