Summary of findings 9. Taxane‐platinum‐fluoropyrimidine combinations versus taxane‐platinum (without fluoropyrimidine) for advanced gastric cancer.
| Taxane‐platinum‐fluoropyrimidine combinations versus taxane‐platinum (without fluoropyrimidine) for advanced gastric cancer | ||||||
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Patient or population: people with advanced gastric cancer
Settings: outpatient clinics participating in international multicentre studies, without Asian representation
Intervention: taxane‐platinum‐fluoropyrimidine combinations Control: taxane‐platinum (without fluoropyrimidine) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Taxane‐platinum (without fluoropyrimidine) | Taxane‐platinum‐fluoropyrimidine combination | |||||
| Overall survival | Study population | OR 0.86 (0.71 to 1.06) | 482 (3 studies) | ⊕⊝⊝⊝ very low1,2 | Weighted average of median survival durations from included studies | |
| 10.0 months | 11.7 months | |||||
| Tumour response | Study population | OR 2.08 (1.37 to 3.15) | 482 (3 studies) | ⊕⊕⊝⊝ low1,3 | ||
| 234 per 1000 | 389 per 1000 (295 to 491) | |||||
| Moderate | ||||||
| 231 per 1000 | 385 per 1000 (292 to 486) | |||||
| Progression‐free survival | Study population | OR 0.74 (0.59 to 0.93) | 482 (3 studies) | ⊕⊕⊕⊝ moderate1 | Weighted average of median survival durations from included studies | |
| 4.4 months | 5.7 months | |||||
| Treatment‐related death | Study population | OR 1.95 (0.73 to 5.17) | 482 (3 studies) | ⊕⊝⊝⊝ very low1,4 | ||
| 26 per 1000 | 50 per 1000 (19 to 121) | |||||
| Moderate | ||||||
| 13 per 1000 | 25 per 1000 (10 to 64) | |||||
| Treatment discontinuation due to toxicity | Study population | OR 1.71 (0.79 to 3.69) | 234 (2 studies) | ⊕⊝⊝⊝ very low1,4 | ||
| 105 per 1000 | 167 per 1000 (85 to 303) | |||||
| Moderate | ||||||
| 99 per 1000 | 158 per 1000 (80 to 288) | |||||
| *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; | ||||||
| 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 one level for imprecision. 4 Downgraded by two levels for serious imprecision.