Efficacy and safety of different molecular targeted agents based on chemotherapy for gastric cancer patients treatment: a network meta-analysis

Abstract

Increasing numbers of reports have been published to demonstrate that molecular targeted agents are able to improve the efficacy of chemotherapy in gastric cancer. This network meta-analysis aimed to evaluate the efficacy and safety of different molecular targeted agents, which were divided into six groups based on the targets including hepatocyte growth factor receptor (c-MET), vascular endothelial factor and its receptor (VEGF/VEGFR), human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), mammalian target of rapamycin (mTOR) and tyrosine kinase inhibitor (TKI). These six groups of targeted agents were evaluated for their efficacy outcomes measured by overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). While their safety was measured 7 adverse events, including fatigue, anaemia, vomiting, neutropenia, thrombocytopenia, diarrhea and nausea. A total of 23 articles were included after extensive searching and strict inclusion, HER2 and VEGF(R) turned out to be the two most effective targeted drugs for their outstanding performance in OS and PFS. However, they were associated with severe adverse events, including fatigue, neutropenia and diarrhea. Therefore, they should be used with caution during their application. In conclusion, VEGF(R) and HER2 have the potential to be the optimal target agents for their survival efficacy, while the adverse events associated with them should be paid attention in application.

Quantitative Analysis of HER2 Amplification by Droplet Digital PCR in the Follow-Up of Gastric Cancer Patients Being Treated with Trastuzumab after Surgery

“…Recently, accumulating evidences regarding the efficacy of novel targeted therapies in the treatment of GC have been reported [5–9], such as human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and vascular endothelial factor and its receptor (VEGF/VEGFR) based on the targets. Although the results were mostly not promising, two meta-analyses of randomized trials revealed that HER2 was the most effective of targeted drugs for its outstanding improvement of OS and progression-free survival (PFS) [10, 11].…”

Jianpi Bushen, a Traditional Chinese Medicine Therapy, Combined with Chemotherapy for Gastric Cancer Treatment: A Meta‐Analysis of Randomized Controlled Trials

“…However, about 60% of patients are diagnosed with gastric cancer after the age of 65, and there is a significant risk of performing a surgery on these patients. Therefore, chemotherapy is widely used as a part of treatment of almost all patients with gastric cancer [5]. However, chemotherapy often causes adverse reactions in patients, including fatigue, anemia, vomiting, decreased neutrophils, thrombocytopenia, diarrhea, and nausea.…”

“…However, chemotherapy often causes adverse reactions in patients, including fatigue, anemia, vomiting, decreased neutrophils, thrombocytopenia, diarrhea, and nausea. The National Cancer Institute (NCI) reported that these chemotherapy regimens may produce severe to life-threatening effects (grade 3-4 adverse reactions according to the NCI's Common Toxicity Criteria) [5]. Additionally, drug resistance seriously limits the curative effect of chemotherapy.…”

The Use of (Network) Meta-Analysis in Clinical Oncology

“…However, the results on the efficacy of each specific targeted therapy cannot be generalized patients with no such molecular distinct properties and vice versa. Therefore, these specific patients groups cannot be merged in pair-wise meta-analysis [such as in (52, 53)] and network meta-analyses [such as in (56, 57, 61)]. These studies cannot in fact only be pooled with or included in the same network with studies on the exact same distinct patient subgroups.…”