Evidence map›Paper›PMID 39026378›Full record

ArticleSystematic reviews2024

Utilising systematic reviews to assess potential overtreatment and claim for better evidence-based research: an analysis of anticancer drugs versus supportive care in advanced esophageal cancer.

Marilina Santero, Adriana-Gabriela Meade, Anna Selva, Olga Savall-Esteve, Javier Bracchiglione, Ismael Macías, Leire Leache, Paula Cerdà, Xavier Bonfill Cosp, Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC-Study) Research Group

Abstract read
In one paragraph

Article in Systematic reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

10 authors.

Marilina SanteroUniversitat Autònoma Barcelona, Barcelona, Spain. Marilina.Santero@autonoma.cat.ORCID 0000-0001-5371-0979
Adriana-Gabriela MeadeIberoamerican Cochrane Centre, Institut de Recerca Sant Pau (IR, SANT PAU), Barcelona, Spain.ORCID 0000-0002-7572-3524
Anna SelvaUniversitat Autònoma Barcelona, Barcelona, Spain.ORCID 0000-0001-9345-0251
Olga Savall-EsteveUniversitat Autònoma Barcelona, Barcelona, Spain.
Javier BracchiglioneUniversitat Autònoma Barcelona, Barcelona, Spain.ORCID 0000-0001-8738-2184
Ismael MacíasServicio Oncología Médica, Hospital de Sabadell-Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain.
Leire LeacheUnit of Innovation and Organization, Navarre Health Service, Pamplona, Spain.ORCID 0000-0003-2272-7086
Paula CerdàUniversitat Autònoma Barcelona, Barcelona, Spain.
Xavier Bonfill CospUniversitat Autònoma Barcelona, Barcelona, Spain.ORCID 0000-0003-1530-3509
Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC-Study) Research Group

Funding

Instituto de Salud Carlos III FIS PI18/00034Instituto de Salud Carlos III PFIS FI19/00335
6 · The paper itself

Abstract

backgroundHighlighting the identified gaps in evidence-based research concerning advanced esophageal cancer (EC) treatment and care, this review evaluates the efficacy and safety of anticancer drugs compared to supportive care for advanced EC patients, aiming to assess the appropriateness of usual treatments and identify the gaps that need to be filled with primary research.

methodsWe searched (May 2022) MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Epistemonikos, and trial registries (ClinicalTrials.gov and PROSPERO) for randomised controlled trials (RCTs) comparing anticancer drugs (chemotherapy, immunotherapy, or biological/targeted therapy) with supportive care in advanced EC. The results were summarised using GRADE summary of finding tables.

resultsWe included 15 RCTs. Most studies did not have a special focus on EC, did not detail the treatment lines in all patients, and did not evaluate all outcomes. Anticancer drugs may result in a slight increase in overall survival (OS) (HR 0.78; 95% CI 0.71, 0.86; MD 0.83 months) and better progression-free survival (PFS) (HR 0.56 95% CI 0.49, 0.64, MD 0.68 months), but also may increase toxicity (RR 1.37; 95% CI 1.13, 1.65), without a significant improvement in quality of life. The certainty of evidence was low or very low due to indirectness of results and lack of specific focus on EC in some studies.

conclusionRCTs on advanced EC lack specificity, detailed treatment line information, and evaluation of all relevant outcomes. Moreover, when they find any benefit, this is negligible. Therefore, the certainty to justify anticancer drug treatments instead of supportive care in advanced EC is low or very low, and this information should be actively shared with affected patients. More and better RCTs should be conducted to assess whether any old or new proposed treatment for advanced EC patients provides a better balance of benefits and harms than the supportive care. SYSTEMATIC REVIEW REGISTRATION: The study protocol was registered in OSF ( https://doi.org/10.17605/OSF.IO/7CHX6 ) on 2022-03-29.

Indexed as

Antineoplastic AgentsEsophageal NeoplasmsSystematic Reviews as TopicEvidence-Based MedicineHumansOvertreatmentPalliative CareQuality of LifeRandomized Controlled Trials as TopicAntineoplastic AgentsAdvanced esophageal cancerChemotherapyImmunotherapyMeta-analysisSystematic reviewTargeted therapy

Identifiers

PMID39026378
PMCPMC11256491

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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.