TY - JOUR
T1 - Prognostic and predictive factors for overall survival in metastatic oesophagogastric cancer
T2 - A systematic review and meta-analysis
AU - ter Veer, Emil
AU - van Kleef, Jessy Joy
AU - Schokker, Sandor
AU - van der Woude, Stephanie O.
AU - Laarman, Marety
AU - Haj Mohammad, Nadia
AU - Sprangers, Mirjam A.G.
AU - van Oijen, Martijn G.H.
AU - van Laarhoven, Hanneke W.M.
N1 - Funding Information:
Dr. Nadia Haj Mohammad has served as a consultant for Celgene and BMS. Dr. Martijn G. H. van Oijen has received unrestricted research grants from Bayer, Lilly, Merck Serono and Roche. Prof. Dr. Hanneke W. M. van Laarhoven has served as a consultant for Philips, Celgene, Lilly and Nordic and has received unrestricted research funding from Philips, Bayer, BMS, Celgene, Lilly, Merck Serono, MSD, Nordic and Roche. The other authors have nothing to declare.
Funding Information:
This project is supported by a grant of the Dutch Cancer Society (KWF) , grant number UVA 2014-7000 .
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background: Consistent evidence on prognostic and predictive factors for advanced oesophagogastric cancer is lacking. Therefore, we performed a systematic review and meta-analysis. Methods: We searched PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) databases for phase II/III randomised controlled trials (RCTs) until February 2017 on palliative systemic therapy for advanced oesophagogastric cancer that reported prognostic or predictive factors for overall survival (PROSPERO-CRD42014015177). Prognostic factors were identified from multivariate regression analyses in study reports. Factors were considered potentially clinically relevant if statistically significant (P ≤ 0.05) in multivariate analysis in ≥50% of the total number of patients in the pooled sample of the RCTs and were reported with a pooled sample size of ≥600 patients in the first-line or ≥300 patients in the beyond first-line setting. Predictive factors were identified from time-to-event stratified treatment comparisons and deemed potentially clinically relevant if the P-value for interaction between subgroups was ≤0.20 and the hazard ratio in one of the subgroups was significant (P ≤ 0.05). Results: Forty-six original RCTs were included (n = 15,392 patients) reporting on first-line (n = 33) and beyond first-line therapy (n = 13). Seventeen prognostic factors for overall survival in the first-line and four in the beyond first-line treatment setting were potentially clinically relevant. Twenty-one predictive factors in first-line and nine in beyond first-line treatment setting were potentially relevant regarding treatment efficacy. Conclusions: The prognostic and predictive factors identified in this systematic review can be used to characterise patients in clinical practice, be included in future trial designs, enrich prognostic tools and generate hypotheses to be tested in future research to promote patient-centred treatment.
AB - Background: Consistent evidence on prognostic and predictive factors for advanced oesophagogastric cancer is lacking. Therefore, we performed a systematic review and meta-analysis. Methods: We searched PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) databases for phase II/III randomised controlled trials (RCTs) until February 2017 on palliative systemic therapy for advanced oesophagogastric cancer that reported prognostic or predictive factors for overall survival (PROSPERO-CRD42014015177). Prognostic factors were identified from multivariate regression analyses in study reports. Factors were considered potentially clinically relevant if statistically significant (P ≤ 0.05) in multivariate analysis in ≥50% of the total number of patients in the pooled sample of the RCTs and were reported with a pooled sample size of ≥600 patients in the first-line or ≥300 patients in the beyond first-line setting. Predictive factors were identified from time-to-event stratified treatment comparisons and deemed potentially clinically relevant if the P-value for interaction between subgroups was ≤0.20 and the hazard ratio in one of the subgroups was significant (P ≤ 0.05). Results: Forty-six original RCTs were included (n = 15,392 patients) reporting on first-line (n = 33) and beyond first-line therapy (n = 13). Seventeen prognostic factors for overall survival in the first-line and four in the beyond first-line treatment setting were potentially clinically relevant. Twenty-one predictive factors in first-line and nine in beyond first-line treatment setting were potentially relevant regarding treatment efficacy. Conclusions: The prognostic and predictive factors identified in this systematic review can be used to characterise patients in clinical practice, be included in future trial designs, enrich prognostic tools and generate hypotheses to be tested in future research to promote patient-centred treatment.
KW - Advanced oesophagogastric cancer
KW - Meta-analysis
KW - Palliative systemic therapy
KW - Predictive factors
KW - Prognostic factors
KW - Systematic review
KW - Prognosis
KW - Prospective Studies
KW - Stomach Neoplasms/mortality
KW - Esophageal Neoplasms/mortality
KW - Humans
KW - Survival Analysis
UR - http://www.scopus.com/inward/record.url?scp=85053847034&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2018.07.132
DO - 10.1016/j.ejca.2018.07.132
M3 - Review article
C2 - 30268922
SN - 0959-8049
VL - 103
SP - 214
EP - 226
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -