https://scholars.lib.ntu.edu.tw/handle/123456789/597551
標題: | Systemic therapies for recurrent or metastatic nasopharyngeal carcinoma: a systematic review | 作者: | Prawira A. Oosting S.F. WEI-WU CHEN Delos Santos K.A. Saluja R. Wang L. Siu L.L. Chan K.K.W. Hansen A.R. |
關鍵字: | Advanced disease; Cancer; Chemotherapy; Metastatic; Molecularly targeted agents; Nasopharyngeal; Systematic review | 公開日期: | 2017 | 出版社: | Nature Publishing Group | 卷: | 117 | 期: | 12 | 起(迄)頁: | 1743-1752 | 來源出版物: | British Journal of Cancer | 摘要: | Background: The majority of published studies in recurrent or metastatic nasopharyngeal carcinoma (RM-NPC) are single-arm trials. Reliable modelling of progression-free survival (PFS) and overall survival (OS) outcomes, therefore, is difficult. This study aim to analyse existent literature to estimate the relative efficacy of available systemic regimens in RM-NPC, as well as provide estimates of aggregate OS and PFS. Methods: We conducted a systematic search of MEDLINE, EMBASE and the Cochrane Library to March 2015. Clinical trials (in English only) investigating cytotoxic and molecularly targeted agents in adult patients with RM-NPC were included. All relevant studies were assessed for quality using Downs and Blacks (DB) checklist (maximum quality score of 27). Aggregate data analysis and Student’s t-test were performed for all identified studies (model A). For studies that published analysable Kaplan – Meier curves, survival data were extracted and marginal proportional hazards models were constructed (model B). Results: A total of 56 studies were identified and included in model A, 26 of which had analysable Kaplan – Meier curves and were included in model B. The 26 studies in model B had significantly higher mean DB scores than the remaining 30 (17.3 vs 13.7, P=0.002). For patients receiving first line chemotherapy, the estimated median OS was 15.7 months by model A (95% CI, 12.3–19.1), and 19.3 months by model B (95% CI, 17.6–21.1). For patients undergoing second line or higher therapies (2nd?), the estimated median OS was 11.5 months by model A (95% CI 10.1–12.9), and 12.5 months by model B (95% CI 11.9–13.4). PFS estimates for patients undergoing first-line chemotherapy by model A was 7.6 months (95% CI, 6.2–9.0), and 8.0 months by model B (95% CI, 7.6–8.8). For patients undergoing therapy in the 2nd? setting, the estimated PFS by model A was 5.4 months (95% CI, 3.8–7.0), and 5.2 months by model B (95% CI, 4.7–5.6). Conclusions: We present the first aggregate estimates of OS and PFS for RM-NPC patients receiving first and second-line or higher treatment settings, which could inform the design of future clinical trials in this disease setting. ? 2017 Cancer Research UK. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85038376720&doi=10.1038%2fbjc.2017.357&partnerID=40&md5=a71c7a886ab68f161b3ece09342be87b https://scholars.lib.ntu.edu.tw/handle/123456789/597551 |
ISSN: | 0007-0920 | DOI: | 10.1038/bjc.2017.357 | SDG/關鍵字: | antineoplastic agent; molecular therapy agent; platinum derivative; platinum derivative; cancer chemotherapy; cancer combination chemotherapy; cancer patient; cancer recurrence; cancer survival; drug efficacy; human; metastasis; molecularly targeted therapy; nasopharynx carcinoma; overall survival; priority journal; progression free survival; recurrent disease; Review; systematic review; systemic therapy; treatment outcome; treatment response; carcinoma; clinical trial (topic); disease free survival; Kaplan Meier method; nasopharynx tumor; pathology; proportional hazards model; secondary; standards; survival rate; tumor recurrence; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Clinical Trials as Topic; Disease-Free Survival; Humans; Kaplan-Meier Estimate; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Platinum Compounds; Proportional Hazards Models; Survival Rate |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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