Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer.

Gastric cancer is a very common gastrointestinal malignancy. Since the disease is often asymptomatic in its early stage, it is often diagnosed in its late stage. In this study, our objective was to evaluate the efficacy and safety of combination chemotherapy regimens containing taxanes in the first-line treatment of advanced gastric cancer (AGC). We searched published randomized controlled trials (RCTs) to compare the effect of taxanes combined with basic chemotherapy and chemotherapy without taxanes on AGC. The extracted data are the number of people who achieved the objective response rate (ORR) and disease control rate (DCR), as well as the hazard ratio (HR) of progression-free survival (PFS) and overall survival (OS) including their 95% confidence intervals (95% CI). Six RCTs involving 2263 patients were included. Compared with chemotherapy without taxanes, patients receiving taxanes combined with basic chemotherapy had significantly longer PFS (HR 0.73, 95% CI 0.61-0.88, p = 0.001) and significantly longer OS (HR 0.80, 95% CI 0.69-0.93, p = 0.003); significantly better ORR (RR 1.34, 95% CI 1.15-1.57, p = 0.0001) and significantly better DCR (RR 1.20, 95% CI 1.08-1.33, p = 0.001). However, in patients treated with taxanes combined with basic chemotherapy, diarrhea, leukopenia and neutropenia were significantly increased (p < 0.05). In summary, taxanes combined with basic chemotherapy are superior to chemotherapy without taxanes in first-line treatment of AGC patients.