Summary of findings for the main comparison. Chemotherapy versus best supportive care for advanced gastric cancer.
| Chemotherapy versus best supportive care for advanced gastric cancer | ||||||
|
Patient or population: people with advanced gastric cancer
Settings: outpatient clinics participating in international multicentre studies
Intervention: chemotherapy Control: best supportive care alone | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Best supportive care | Chemotherapy | |||||
| Overall survival | Study population | HR 0.37 (0.24 to 0.55) | 184 (3 studies) | ⊕⊕⊕⊝ moderate1 | Weighted average of median survival durations from included studies | |
| 4.3 months | 11.0 months | |||||
| Time to progression | Study population | HR 0.31 (0.22 to 0.43) | 144 (2 studies) | ⊕⊕⊕⊝ moderate1 | Weighted average of median survival durations from included studies | |
| 2.5 months | 7.4 months | |||||
| *For time‐to‐event outcomes, e.g. overall survival, the assumed and corresponding risks were obtained by calculating the weighted average of the median survival durations reported in included studies. For dichotomous outcomes, the assumed and corresponding risks (and their 95% confidence interval) are based on proportions of events in the control and intervention groups respectively. CI: Confidence interval; HR: Hazard ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Early termination of Pyrhönen 1995; downgraded by one level for risk of bias.
Outcomes shown include those which were measured in the studies, or reported in a consistent fashion across included studies. Several critical outcomes (e.g. tumour response, treatment‐related death, and discontinuation due to toxicity) were not evaluated or reported in a consistent fashion in these studies, as they were mainly conducted before year 2000.