The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis

Li, Yan; Zhou, Yaoyao; Hong, Yonglan; He, Meizhi; Wei, Shuyi; Yang, Chen; Zheng, Dayong; Liu, Feiye

doi:10.2139/ssrn.3335000

Cited by 4 publications

(6 citation statements)

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“…The findings explain why medicine has been failed to find cures [59][60][61][62][63][64][65][66][67]. The failure is most clearly reflected in cancer research: Drug performance is very poor based on randomly selected reviews for cancer drugs and treatments [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86]. Drug performance is inflated by all model flaws [9], and their real benefits-to-risks ratios are magnitudes lower [1].…”

Section: B Medicine Developed On Flawed Foundationmentioning

confidence: 99%

“…The partnership between the drug industry and the publishing industry become even more important after 1980. Massive post-1980 research findings [46, [69][70][71][72][73][74][75][76][77][78][79][80][81][82][138][139][140][141][142][143][144][145][146] started showing failure of drugs. Thus, the drug-for-health hypothesis is constantly under challenge and the need to use alternative health measures arose.…”

Section: Flawed Medicine Has Been Hijacked To Advance Trade Revenue But Never Curesmentioning

confidence: 99%

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CITIZEN PETITION FOR REGULATORY ACTION TO REEVALUATE ALL MRNA VACCINES AND REVOKE THEIR USE AUTHORIZATIONS (1st Rev.)

Wu¹

2022

Preprint

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Jianqing Wu, Ph.D., J.D, hereby submits this citizen petition to the Commissioner of the U.S. Food and Drug Administration (FDA) under the federal Food, Drug, and Cosmetic Act (FDCA), 21 U.S.C. § 355, 21 U.S. § 564(g)(2), 21 U.S. Code § 379dd, 21 C.F.R. §§ 1.21, 7.40(b), 42 U.S. § 262(a)(2), and the Administrative Procedure Act (APA), 5 U.S.C. §553(e). Petitioner requests FDA to suspend all outstanding mRNA vaccine use authorizations, re-evaluate their effectiveness and safety, and revoke their use authorizations as soon as possible, and make a plan to systematically overhaul its approval framework.

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Section: B Medicine Developed On Flawed Foundationmentioning

confidence: 99%

Section: Flawed Medicine Has Been Hijacked To Advance Trade Revenue But Never Curesmentioning

confidence: 99%

CITIZEN PETITION FOR REGULATORY ACTION TO REEVALUATE ALL MRNA VACCINES AND REVOKE THEIR USE AUTHORIZATIONS (1st Rev.)

Wu¹

2022

Preprint

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“…Network meta-analysis has the advantage of combining direct and indirect evidence and can make up for the deficiency of traditional meta-analysis. In order to further summarize various evidences, in addition to the conventional meta-analysis, four mesh meta-analyses were included in this study [30][31][32][33] (Table 2). Yan Li et al [30] found in the comparison of 18 chemotherapy schemes and best support therapy (BSC),that the curative effect of FOLFOX-4 chemotherapy scheme is the most significant in these schemes (HR=3.4, 95% CI 1.70-6.70).This suggests that FOLFOX-4 regimen may have the potential to be the best chemotherapy regimen for patients with advanced BTC.…”

Section: Comparison Between Chemotherapy and Targeted Therapy Regimen...mentioning

confidence: 99%

“…In order to further summarize various evidences, in addition to the conventional meta-analysis, four mesh meta-analyses were included in this study [30][31][32][33] (Table 2). Yan Li et al [30] found in the comparison of 18 chemotherapy schemes and best support therapy (BSC),that the curative effect of FOLFOX-4 chemotherapy scheme is the most significant in these schemes (HR=3.4, 95% CI 1.70-6.70).This suggests that FOLFOX-4 regimen may have the potential to be the best chemotherapy regimen for patients with advanced BTC. As we all know, gemcitabine+platinum (GP or GC), which has been used as a standard first -line chemotherapy scheme for advanced biliary cancer.…”

Section: Comparison Between Chemotherapy and Targeted Therapy Regimen...mentioning

confidence: 99%

Chemotherapy and targeted therapy for advanced biliary tract cancers：An umbrella review

Wang

Wen

Wang

et al. 2022

Preprint

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Background: Malignant tumors of the biliary system have high malignancy and strong invasiveness, and are usually found in late stages with poor prognosis. For patients with advanced biliary tract cancer, chemotherapy and targeted therapy are one of the options to improve prognosis and delay tumor progression. The purpose of this study was to comprehensively evaluate the safety and efficacy of various chemotherapy regimenfor advanced biliary carcinoma. Methods : An umbrella review method was adopted, which aims to summarize the evidence from multiple studies around a research topic. Evidence from meta analyses up to 09 April 2022 were identified using PubMed, Web of Science, the Cochrane database, as well as manual screening. Eligible studies were screened according to inclusion and exclusion criteria. This study had been registered at PROSPERO (CRD42022324548).For each eligible study, we extracted the data of general characteristics and the main findings. The methodological quality of the included studies were assessed by AMSTAR2 and the quality of evidence was evaluated by the GRADE. Results : A total of 1833 articles were searched, 14 unique articles with 94 outcomes were identified by eligibility criteria. The incidence of skin rash (RR=18.11,95%CI 5.13-63.91) and diarrhea (RR=2.48,95%CI 1.2-5.10) was higher in patients receiving gemcitabine-based chemotherapy plus targeted therapy than in patients receiving gemcitabine alone. Patients receiving gemcitabine-containing chemotherapy developed leukopenia (OR=7.17, 95%CI 1.43-36.08), anemia (OR=7.04, 95%CI 2.59-19.12), thrombocytopenia (RR=2.45, 95%CI 1.39-4.32) and neutropenia (RR=3.30, 95%CI 1.04-10.50) were significantly higher than gemcitabine-free regimens. In addition, patients receiving S-1 monotherapy had significantly better ORR (RR=2.46,95%CI 1.27-4.57) than patients receiving S-1+gemcitabine. Patients receiving fluoropyrimidine-based chemotherapy had longer OS (HR=0.83, 95%CI 0.7-0.99), higher DCR (0R=5.18, 95%CI 3.3-10.23), and higher ORR (0R=3.24, 95%CI 1.18-8.92) compared with 5-FU/LV monotherapy or supportive therapy. Surprisingly, there was also evidence that gemcitabine-based chemotherapy did not improve postoperative patients' OS (HR=0.91, 95%CI 0.74-1.12) when compared with best supportive care. Conclusions: This study comprehensively evaluated the safety and efficacy of chemotherapy or targeted therapy regimens for advanced biliary tract cancer and found 11 "moderate" or "high" levels of evidence, however, most of the evidence was still at "low" or "very low" levels. More randomized controlled studies are needed in the future to further summarize high-level evidence.

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“…It is because most patients with CCA tend to be diagnosed at an advanced stage 6 —with the majority of patients presenting with metastatic disease and unresectable tumours 61 —that prevents continuation of potentially curative therapies. Also, given the limited effectiveness of current standard chemotherapy (gemcitabine and cisplatin) in treating advanced CCA, 62 it is possible that the increased survival rate in patients with CCA was related to another treatment, that is, aspirin.…”

Section: Evidence For An Anticancer Effect Of Aspirin On Ccamentioning

confidence: 99%

A potential role for aspirin in the prevention and treatment of cholangiocarcinoma

Shen

2020

Intl Journal of Cancer

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Cholangiocarcinoma is the second most common primary hepatic cancer, with a rising incidence worldwide. Owing to late diagnosis and limited treatment options, the prognosis for cholangiocarcinoma remains dismal, compelling a search for new treatments. As aspirin exhibits a well‐supported chemopreventive effect on common cancers, researchers have proposed using aspirin as a potential preventive and adjuvant agent for cholangiocarcinoma. In the present review of the literature, we provide a background on cholangiocarcinoma and potential mechanisms of action underlying the anticancer effect of aspirin. Although the exact mode of action remains unclear, multiple downstream effects of aspirin may interfere with cholangiocarcinogenesis, tumour growth and metastasis—including inhibiting the COX‐2 pathway, preventing platelet aggregation and modulating certain proteins and signalling. This review also summarises evidence to support the chemopreventive effects of aspirin on common cancers, particularly colorectal cancer and discusses studies that report a positive outcome of aspirin in cholangiocarcinoma. Regular use of aspirin is associated with a reduced incidence of colorectal cancers as well as cholangiocarcinomas, and improved survival. Aspirin thus appears to play a role in the primary prevention and treatment of cholangiocarcinoma. However, further studies are needed to confirm these benefits and to establish a cause‐and‐effect relationship.

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The Efficacy of Different Chemotherapy Regimens for Advanced Biliary Tract Cancer: A Systematic Review and Network Meta-Analysis

Cited by 4 publications

References 0 publications

CITIZEN PETITION FOR REGULATORY ACTION TO REEVALUATE ALL MRNA VACCINES AND REVOKE THEIR USE AUTHORIZATIONS (1st Rev.)

CITIZEN PETITION FOR REGULATORY ACTION TO REEVALUATE ALL MRNA VACCINES AND REVOKE THEIR USE AUTHORIZATIONS (1st Rev.)

Chemotherapy and targeted therapy for advanced biliary tract cancers：An umbrella review

A potential role for aspirin in the prevention and treatment of cholangiocarcinoma

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