Efficacy of systemic oncological treatments in patients with advanced pancreatic cancer at high risk of dying in the short or medium-term: overview of systematic reviews
Por:
Salazar, J, Perez-Bracchiglione, J, Salas-Gama, K, Antequera, A, Auladell-Rispau, A, Dorantes-Romandia, R, Meade, AG, Quintana, MJ, Requeijo, C, Rodriguez-Grijalva, G, Santero, M, Acosta-Dighero, R, Sola, I, Urrutia, G, Cosp, XB, Systemic Treatments Adv Digestive
Publicada:
1 sep 2021
Ahead of Print:
1 jul 2021
Resumen:
Background: Patients with advanced pancreatic cancer (PC) have a high risk of dying in the short or medium-term. This overview aimed to assess the evidence regarding systemic oncological treatments (SOT) versus supportive care for advanced PC.
Methods: We searched for systematic reviews (SRs) in MEDLINE, Embase, The CochraneLibrary, Epistemonikos, and PROSPERO. Two authors assessed eligibility independently. Data extraction and methodological quality assessment were conducted by one author and cross-checked by another one. We evaluated the overlap of primary studies, performed a de novo meta-analysis, and assessed the certainty of evidence. Primary outcomes were overall survival (OS), quality of life (QoL), functional status (FS), and toxicity.
Results: We identified three SRs that assessed SOT versus supportive care in patients with advanced PC. All SRs had critically low methodological quality. At 12 months, OS improved with chemotherapy, radiotherapy followed by chemotherapy, and immunotherapy, but the certainty of the evidence supporting these findings is very low. The evidence on chemotherapy is very uncertain about its effects on QoL; it suggests a slight increase in toxicity and little to no difference in FS. The evidence on immunotherapy is very uncertain about its effects in toxicity.
Conclusions: The identified evidence is very uncertain about the benefits of oncological treatments on OS and QoL in patients with advanced PC with a high risk of dying in the short or medium-term, so its use should be proposed only to selected patients. Further studies that include a thorough assessment of patient-centred outcomes are needed. (C) 2021 Published by Elsevier Ltd.
Filiaciones:
Salazar, J:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Perez-Bracchiglione, J:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Univ Valparaiso, Interdisciplinary Ctr Hlth Studies CIESAL, Vina Del Mar, Chile
Salas-Gama, K:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Antequera, A:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Auladell-Rispau, A:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Dorantes-Romandia, R:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Meade, AG:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Quintana, MJ:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Requeijo, C:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Rodriguez-Grijalva, G:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Santero, M:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
Acosta-Dighero, R:
Univ San Sebastian, Sch Physiotherapy, Fac Hlth Sci, Santiago, Chile
Sola, I:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Urrutia, G:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Cosp, XB:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, C St Antoni M Claret 167,Pavello 18 Planta 0, Barcelona 08025, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
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