PMID- 29455269
OWN - NLM
STAT- MEDLINE
DCOM- 20180924
LR  - 20220330
IS  - 1436-3305 (Electronic)
IS  - 1436-3291 (Linking)
VI  - 21
IP  - 3
DP  - 2018 May
TI  - The efficacy and safety of targeted therapy with or without chemotherapy in 
      advanced gastric cancer treatment: a network meta-analysis of well-designed 
      randomized controlled trials.
PG  - 361-371
LID - 10.1007/s10120-018-0813-2 [doi]
AB  - BACKGROUND: Advanced gastric cancer (AGC) is a severe malignant tumor associated 
      with high mortality. Targeted therapy is an important approach for improving the 
      therapeutic effects of AGC treatment. This study evaluates the efficacy and 
      safety of targeted agents for AGC patients. METHODS: PubMed, EmBase, and the 
      Cochrane Library were searched for double-blind randomized controlled trials 
      (RCTs) of AGC treatments published prior to July 2017. Progression-free survival 
      (PFS), overall survival (OS), objective response rate (ORR), and severe adverse 
      effects (AEs) were evaluated to determine the efficacy and safety of targeted 
      agents. A network meta-analysis with a frequentist framework was performed to 
      assess the effects of various targeted agents for AGC treatment. RESULTS: Our 
      analysis included 16 articles involving 5371 patients and 11 types of agents. The 
      network meta-analysis showed that apatinib (97.5%) was most likely to improve 
      PFS, followed by regorafenib (86.3%) and rilotumumab (65.4%). Apatinib was 
      similarly best for OS outcome, (95.5%) followed by rilotumumab (74.7%) and 
      regorafenib (70%). Apatinib (89.6%) also had the best improvement on ORR, 
      followed by rilotumumab (75.4%) and everolimus (68.4%). Bevacizumab (85.5%) was 
      likely to get the lowest severe AEs, followed by sunitinib (63%). CONCLUSIONS: 
      Apatinib, regorafenib, and rilotumumab improved patient PFS and OS. When combined 
      with chemotherapy, ramucirumab and rilotumumab had high efficacy but low 
      tolerability, and bevacizumab had moderate efficacy and tolerability for PFS. 
      Without chemotherapy, ramucirumab and regorafenib had relatively high therapeutic 
      efficacy tolerability for PFS.
FAU - Zhao, Ting-Ting
AU  - Zhao TT
AD  - Department of Breast Surgery, First Hospital of China Medical University, 
      Shenyang, Liaoning, China.
FAU - Xu, Hao
AU  - Xu H
AD  - Department of Medical Oncology, Shengjing Hospital of China Medical University, 
      Shenyang, Liaoning, China.
FAU - Xu, Hui-Mian
AU  - Xu HM
AD  - Department of Surgical Oncology, First Hospital of China Medical University, 
      Shenyang, 110001, Liaoning, China.
FAU - Wang, Zhen-Ning
AU  - Wang ZN
AD  - Department of Surgical Oncology, First Hospital of China Medical University, 
      Shenyang, 110001, Liaoning, China.
FAU - Xu, Ying-Ying
AU  - Xu YY
AD  - Department of Breast Surgery, First Hospital of China Medical University, 
      Shenyang, Liaoning, China.
FAU - Song, Yong-Xi
AU  - Song YX
AD  - Department of Surgical Oncology, First Hospital of China Medical University, 
      Shenyang, 110001, Liaoning, China.
FAU - Yin, Song-Cheng
AU  - Yin SC
AD  - Department of Surgical Oncology, First Hospital of China Medical University, 
      Shenyang, 110001, Liaoning, China.
FAU - Liu, Xing-Yu
AU  - Liu XY
AD  - Department of Surgical Oncology, First Hospital of China Medical University, 
      Shenyang, 110001, Liaoning, China.
FAU - Miao, Zhi-Feng
AU  - Miao ZF
AD  - Department of Surgical Oncology, First Hospital of China Medical University, 
      Shenyang, 110001, Liaoning, China. zfmiao@cmu.edu.cn.
LA  - eng
GR  - 81272718/National Natural Science Foundation of China/
GR  - 81302125/National Natural Science Foundation of China/
GR  - 81372550/National Natural Science Foundation of China/
PT  - Journal Article
PT  - Multicenter Study
PT  - Review
DEP - 20180217
PL  - Japan
TA  - Gastric Cancer
JT  - Gastric cancer : official journal of the International Gastric Cancer Association 
      and the Japanese Gastric Cancer Association
JID - 100886238
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/*therapeutic use
MH  - Disease-Free Survival
MH  - Humans
MH  - Molecular Targeted Therapy/*methods
MH  - Stomach Neoplasms/*drug therapy/mortality
OTO - NOTNLM
OT  - Advanced gastric cancer
OT  - Clinical treatment
OT  - Meta-analysis
OT  - Targeted therapy
EDAT- 2018/02/20 06:00
MHDA- 2018/09/25 06:00
CRDT- 2018/02/19 06:00
PHST- 2017/09/13 00:00 [received]
PHST- 2018/02/05 00:00 [accepted]
PHST- 2018/02/20 06:00 [pubmed]
PHST- 2018/09/25 06:00 [medline]
PHST- 2018/02/19 06:00 [entrez]
AID - 10.1007/s10120-018-0813-2 [pii]
AID - 10.1007/s10120-018-0813-2 [doi]
PST - ppublish
SO  - Gastric Cancer. 2018 May;21(3):361-371. doi: 10.1007/s10120-018-0813-2. Epub 2018 
      Feb 17.