title: Cisplatin/gemcitabine or oxaliplatin/gemcitabine in the treatment of advanced biliary tract cancer: a systematic review.
abstract: Cisplatin/gemcitabine association has been a standard of care for first-line regimen in advanced biliary tract cancer nevertheless oxaliplatin/gemcitabine regimen is frequently preferred. Because comparative effectiveness in clinical outcomes of cisplatin- versus oxaliplatin-containing chemotherapy is not available, a systematic review of studies assessing cisplatin/gemcitabine or oxaliplatin/gemcitabine chemotherapies in advanced biliary tract cancer was performed. Published studies evaluating cisplatin/gemcitabine or oxaliplatin/gemcitabine in advanced biliary tract cancer were included. Each study was weighted according to the number of patients included. The primary objective was to assess weighted median of medians overall survival (mOS) reported for both regimens. Secondary goals were to assess weighted median of medians progression-free survival (mPFS) and toxic effects were pooled and compared within each arm. Thirty-three studies involving 1470 patients were analyzed. In total, 771 and 699 patients were treated by cisplatin/gemcitabine and oxaliplatin/gemcitabine, respectively. Weighted median of mOS was 9.7 months in cisplatin group and 9.5 months in oxaliplatin group. Cisplatin-based chemotherapy was significantly associated with more grade 3 and 4 asthenia, diarrhea, liver toxicity, and hematological toxicity. Sensitivity analysis including only the studies with the standard regimen of cisplatin (25-35 mg/m(2) administered on days 1 and 8) showed that the weighted median of mOS increased from 9.7 to 11.7 months but Gem/CDDP regimen remained more toxic than Gemox regimen. These results suggest that the Gem/CDDP regimen with cisplatin (25-35 mg/m(2)) administered on days 1 and 8 is associated with survival advantage than Gemox regimen but with addition of toxicity.
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon, France; Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Fiteni
authors.forename: Thierry
authors.initials: T
authors.lastname: Nguyen
authors.forename: Dewi
authors.initials: D
authors.lastname: Vernerey
authors.forename: Marie-Justine
authors.initials: MJ
authors.lastname: Paillard
authors.forename: Stefano
authors.initials: S
authors.lastname: Kim
authors.forename: Martin
authors.initials: M
authors.lastname: Demarchi
authors.forename: Francine
authors.initials: F
authors.lastname: Fein
authors.forename: Christophe
authors.initials: C
authors.lastname: Borg
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.forename: Xavier
authors.initials: X
authors.lastname: Pivot
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D016032:Randomized Controlled Trials as Topic; D000093542:Gemcitabine
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine
keywords: Biliary tract cancer; cisplatin; gemcitabine; oxaliplatin
references.citation: Cancer Chemother Pharmacol. 2008 Jan;61(1):47-52
references.pmid: 17364190
references.citation: Dig Dis Sci. 2008 Feb;53(2):564-70
references.pmid: 17597402
references.citation: Br J Cancer. 2006 Oct 9;95(7):848-52
references.pmid: 16969352
references.citation: Cancer. 2006 Mar 15;106(6):1339-46
references.pmid: 16475213
references.citation: Br J Cancer. 2010 Aug 10;103(4):469-74
references.pmid: 20628385
references.citation: Br J Cancer. 2009 Aug 18;101(4):621-7
references.pmid: 19672264
references.citation: World J Gastroenterol. 2007 May 28;13(20):2852-4
references.pmid: 17569122
references.citation: Ann Oncol. 1996 Aug;7(6):593-600
references.pmid: 8879373
references.citation: Eur J Cancer. 2005 Feb;41(3):398-403
references.pmid: 15691639
references.citation: Br J Cancer. 2007 Mar 26;96(6):896-902
references.pmid: 17325704
references.citation: Ann Oncol. 2004 Mar;15(3):478-83
references.pmid: 14998852
references.citation: N Engl J Med. 2010 Apr 8;362(14):1273-81
references.pmid: 20375404
references.citation: Eur J Gastroenterol Hepatol. 2010 Sep;22(9):1111-7
references.pmid: 20386107
references.citation: Gastrointest Cancer Res. 2011 Sep;4(5-6):155-60
references.pmid: 22295126
references.citation: Cancer Chemother Pharmacol. 2010 Feb;65(3):497-502
references.pmid: 19575200
references.citation: Oncology. 2007;73(5-6):311-5
references.pmid: 18493158
references.citation: Ann Oncol. 2006 Jun;17 Suppl 7:vii73-7
references.pmid: 16760299
references.citation: J Clin Oncol. 2010 Oct 20;28(30):4581-6
references.pmid: 20855823
references.citation: Ann Oncol. 2006 Jun;17 Suppl 7:vii68-72
references.pmid: 16760298
references.citation: Am J Clin Oncol. 2003 Apr;26(2):174-7
references.pmid: 12714891
references.citation: Cancer Chemother Pharmacol. 2011 Mar;67(3):519-25
references.pmid: 20461378
references.citation: J Gastroenterol Hepatol. 2006 Jun;21(6):999-1003
references.pmid: 16724985
references.citation: Lancet Oncol. 2012 Feb;13(2):181-8
references.pmid: 22192731
references.citation: Br J Cancer. 2008 Sep 16;99(6):862-7
references.pmid: 19238628
references.citation: Cancer Chemother Pharmacol. 2009 Jul;64(2):371-7
references.pmid: 19142638
references.citation: Br J Cancer. 2004 Apr 19;90(8):1516-20
references.pmid: 15083178
references.citation: Br J Cancer. 2005 May 9;92(9):1650-4
references.pmid: 15856037
references.citation: Ann Oncol. 2005 Feb;16(2):279-81
references.pmid: 15668284
references.citation: Dig Liver Dis. 2011 Jan;43(1):60-5
references.pmid: 20580332
references.citation: Oncology. 2006;70(4):280-4
references.pmid: 17047399
references.citation: Chemotherapy. 2010;56(3):234-8
references.pmid: 20551640
references.citation: Cancer Chemother Pharmacol. 2010 Mar;65(4):641-7
references.pmid: 19652971