Evidence map›Paper›PMID 39763666›Full record

SynthesisFrontiers in immunology2024

Durvalumab and pembrolizumab in advanced biliary tract cancer: a reconstructed patient-level mimic head-to-head comparative analysis.

Bi-Cheng Wang, Bo-Hua Kuang, Guo-He Lin, Chen Fu

Abstract readComparative StudySystematic Review
In one paragraph

Synthesis in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
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

4 authors.

Bi-Cheng WangCancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Bo-Hua KuangCancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Guo-He LinDepartment of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Chen FuWuhan No.1 Hospital, Wuhan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The addition of durvalumab or pembrolizumab to gemcitabine and cisplatin (GP) has been approved to statistically improve survival outcomes in patients with advanced biliary tract cancer. However, since the survival time was only prolonged by about two months, doubts have been raised. In this analysis, we aimed to evaluate the efficacy of combining durvalumab or pembrolizumab with GP chemotherapy. Methods: Records were identified through a formal search of PubMed and Web of Science. The TOPAZ-1 and KEYNOTE-966 trials were definitively included. Patient-level overall survival (OS) and progression-free survival (PFS) data were reconstructed and analyzed using a one-stage approach. Results: The immunotherapy plus GP chemotherapy group showed superiority over the GP chemotherapy group (OS: HR 0.83, p < 0.001; PFS: HR 0.88, p = 0.009). The survival outcomes were similar between the durvalumab and pembrolizumab groups (OS: HR 1.02, p = 0.83; PFS: HR 0.95, p = 0.53). In the subgroup analysis, the gemcitabine-maintenance group significantly prolonged the OS compared to the gemcitabine-limited-to-8-cycles group (OS: HR 0.86, p = 0.007). Neither the durvalumab nor pembrolizumab groups statistically improved the OS compared to the gemcitabine-maintenance group. In contrast, the durvalumab and pembrolizumab groups significantly improved OS compared to the gemcitabine-limited-to-8-cycles group. Conclusions: Based on this mimic head-to-head analysis, we are convinced that durvalumab and pembrolizumab benefit patients with biliary tract cancer. However, despite the statistically significant differences, the moderate progress made in OS and PFS might still be considered inadequate. It is crucial for clinicians to identify the precise subgroup population that could benefit most from immunotherapy and develop more strategies for those who might not respond well to immunotherapy.

Indexed as

Antibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBiliary Tract NeoplasmsAntineoplastic Agents, ImmunologicalCisplatinDeoxycytidineGemcitabineHumansMaleTreatment OutcomeAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalCisplatinDeoxycytidinedurvalumabGemcitabinepembrolizumabbiliary tract cancerchemotherapydurvalumabmimic head-to-head comparative analysispembrolizumab

Identifiers

PMID39763666
PMCPMC11701065

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Registered trials

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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.