title: Chemotherapy for Late-Stage Cancer Patients: Meta-Analysis of Complete Response Rates.
abstract: Complete response (CR) rates reported for cytotoxic chemotherapy for late-stage cancer patients are generally low, with few exceptions, regardless of the solid cancer type or drug regimen. We investigated CR rates reported in the literature for clinical trials using chemotherapy alone, across a wide range of tumour types and chemotherapeutic regimens, to determine an overall CR rate for late-stage cancers. A total of 141 reports were located using the PubMed database. A meta-analysis was performed of reported CR from 68 chemotherapy trials (total 2732 patients) using standard agents across late-stage solid cancers-a binomial model with random effects was adopted. Mean CR rates were compared for different cancer types, and for chemotherapeutic agents with different mechanisms of action, using a logistic regression. Our results showed that the CR rates for chemotherapy treatment of late-stage cancer were generally low at 7.4%, regardless of the cancer type or drug regimen used. We found no evidence that CR rates differed between different chemotherapy drug types, but amongst different cancer types small CR differences were evident, although none exceeded a mean CR rate of 11%. This remarkable concordance of CR rates regardless of cancer or therapy type remains currently unexplained, and motivates further investigation.
authors.affiliation: Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Ashdown
authors.affiliation: Department of Mathematics and Statistics, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Robinson
authors.affiliation: Berbay Biosciences, Kew East, Victoria, Australia.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Yatomi-Clarke
authors.affiliation: ImmunAid Pty Ltd, Fitzroy, Victoria, Australia.
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Ashdown
authors.affiliation: Centre for Biomedical Engineering (CBME), University of Adelaide, South Australia, Australia; School of Electrical & Electronic Engineering, University of Adelaide, South Australia, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Allison
authors.affiliation: Centre for Biomedical Engineering (CBME), University of Adelaide, South Australia, Australia; School of Electrical & Electronic Engineering, University of Adelaide, South Australia, Australia.
authors.forename: Derek
authors.initials: D
authors.lastname: Abbott
authors.affiliation: Melanoma Study Group, Mayo Clinic Cancer Cente, Rochester, MN, USA.
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
authors.affiliation: Department of Surgery & Tumour Immunology Laboratory, University of Adelaide, South Australia, Australia; Breast, Endocrine & Surgical Oncology Unit, Royal Adelaide Hospital, South Australia, Australia.
authors.forename: Brendon J
authors.initials: BJ
authors.lastname: Coventry
keywords: Advanced Cancer; Chemotherapy; Complete Response Rates; Meta-analysis; Metastatic Cancer
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