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Gemcitabine based combination chemotherapy in advanced pancreatic cancer-indirect comparison
Asma Sultana1, Paula Ghaneh, David Cunningham
1CRUK Liverpool Cancer Trials Unit, Cancer Research Centre, 200 London Road, Liverpool L3 9TA, UK. asmasul@liv.ac.uk
Background:
Recent meta-analyses have found a survival advantage with gemcitabine based combinations over single agent gemcitabine in patients with advanced pancreatic cancer. There is paucity of evidence in the form of direct head-to-head randomised controlled trials to determine which combinations are to be preferred.
Method:
Using the adjusted indirect comparison method proposed by Bucher et al, we have assessed randomised controlled trials of four gemcitabine based combinations namely gemcitabine plus a platinum compound or 5-fluorouracil or irinotecan or capecitabine.
Results:
No particular combination was significantly superior to another, but the indirect evidence suggests some important trends.
Conclusion:
The strongest trends on indirect comparison are towards favouring gemcitabine plus capecitabine or gemcitabine plus a platinum compound over gemcitabine plus irinotecan, and to a lesser degree, over gemcitabine plus 5-fluorouracil.
