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Evidence summaries

Chemotherapy for Advanced Gastric Cancer

Chemotherapy improves survival compared to best supportive care in patients with advanced gastric cancer. In addition, combination chemotherapy further improves survival compared to single-agent chemotherapy. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 60 studies with a total of 11 698 subjects. Included were RCTs on systemic, intravenous or oral chemotherapy versus best supportive care (BSC), combination versus single-agent chemotherapy and different chemotherapy regimens in advanced gastric cancer.

Chemotherapy extended overall survival (OS) by approximately 6.7 months more than BSC (hazard ratio (HR) 0.3, 95% CI 0.24 to 0.55, 184 participants, three studies). Combination chemotherapy extended OS slightly (by an additional month) versus single-agent chemotherapy (HR 0.84, 95% CI 0.79 to 0.89, 4447 participants, 23 studies), which was partly counterbalanced by increased toxicity.

    References

    • Wagner AD, Syn NL, Moehler M et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 2017;(8):CD004064. [PubMed]

Primary/Secondary Keywords