Summary of findings 10. S‐1 versus 5‐FU‐containing regimens for advanced gastric cancer.
| S‐1 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, mostly performed in Asia
Intervention: S‐1‐containing regimens 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 | S‐1 containing regimens | |||||
| Overall Survival | Study population | HR 0.91 (0.83 to 1.00) | 1793 (4 studies) | ⊕⊕⊕⊕ high | Weighted average of median survival durations from included studies | |
| 9.1 months | 9.6 months | |||||
| Tumour response | Study population | OR 1.73 (1.01 to 2.94) | 1753 (7 studies) | ⊕⊝⊝⊝ very low1,2 | ||
| 256 per 1000 | 374 per 1000 (258 to 503) | |||||
| Moderate | ||||||
| 320 per 1000 | 449 per 1000 (322 to 580) | |||||
| Progression‐free survival | Study population | HR 0.85 (0.70 to 1.04) | 1942 (4 studies) | ⊕⊕⊝⊝ low1 | Weighted average of median survival durations from included studies | |
| 4.3 months | 5.0 months | |||||
| Time‐to treatment failure | Study population | HR 0.88 (0.76 to 1.01) | 1818 (5 studies) | ⊕⊕⊝⊝ low1 | Weighted average of median survival durations from included studies | |
| 3.1 months | 3.9 months | |||||
| Treatment‐related deaths | Study population | OR 0.56 (0.30 to 1.06) | 1962 (4 studies) | ⊕⊕⊕⊝ moderate2 | ||
| 27 per 1000 | 15 per 1000 (8 to 28) | |||||
| Moderate | ||||||
| 5 per 1000 | 3 per 1000 (2 to 5) | |||||
| Treatment discontinuation due to toxicity | Study population | OR 0.85 (0.63 to 1.13) | 1726 (3 studies) | ⊕⊕⊕⊕ high | ||
| 128 per 1000 | 111 per 1000 (85 to 142) | |||||
| Moderate | ||||||
| 144 per 1000 | 125 per 1000 (96 to 160) | |||||
| *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 two levels for severe statistical heterogeneity. 2 Downgraded by one level for imprecision.