Summary of findings 7. Capecitabine versus 5‐FU‐containing regimens for advanced gastric cancer.
| Capecitabine versus 5‐FU‐containing regimens for advanced gastric cancer | ||||||
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Patient or population: people with advanced gastric cancer
Settings: outpatient clinics participating in international multicentre studies with approximately half of all participants enrolled from Asian countries
Intervention: capecitabine Control: 5‐FU‐containing regimens | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| 5‐FU‐containing regimens | Capecitabine‐containing regimens | |||||
| Overall Survival | Study population |
HR 0.94 (0.79 to 1.11) |
732 (5 studies) | ⊕⊕⊕⊝ moderate1 | Weighted average of median survival durations from included studies | |
| 10.9 months | 10.8 months | |||||
| Tumour response | Study population |
OR 0.85 (0.40 to 1.79) |
636 (4 studies) | ⊕⊝⊝⊝ very low2,3 | ||
| 384 per 1000 | 347 per 1000 (200 to 528) | |||||
| Moderate | ||||||
| 394 per 1000 | 356 per 1000 (206 to 538) | |||||
| Time to progression | Study population |
HR 0.72 (0.47 to 1.12) |
85 (1 study) | ⊕⊝⊝⊝ very low1,3 | Median survival durations from the only included study | |
| 5.5 months | 6.8 months | |||||
| Progression‐free survival | Study population |
HR 0.98 (0.77 to 1.23) |
647 (4 studies) | ⊕⊝⊝⊝ very low1,3,4 | Weighted average of median survival durations from included studies | |
| 6.7 months | 6.5 months | |||||
| Treatment‐related death | Study population |
OR 1.88 (0.23 to 15.15) |
481 (2 studies) | ⊕⊝⊝⊝ very low1,2,3 | ||
| 21 per 1000 | 38 per 1000 (5 to 241) | |||||
| Moderate | ||||||
| 24 per 1000 | 44 per 1000 (6 to 271) | |||||
| Treatment discontinuation due to toxicity | Study population |
OR 0.99 (0.56 to 1.77) |
311 (1 study) | ⊕⊕⊝⊝ low3 | ||
| 181 per 1000 | 179 per 1000 (110 to 281) | |||||
| Moderate | ||||||
| 181 per 1000 | 180 per 1000 (110 to 281) | |||||
| *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; OR: Odds ratio; 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 Downgraded by one level for risk of bias. 2 Downgraded by two levels for severe statistical heterogeneity. 3 Downgraded by two levels for serious imprecision. 4 Downgraded by one level for statistical heterogeneity.