title: Comparative effectiveness and safety between oxaliplatin-based and cisplatin-based therapy in advanced gastric cancer: A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Platinum-based drugs are the most significant chemotherapy for advanced gastric cancer. The study aims to compare the efficacy and safety of oxaliplatin-based therapy versus cisplatin-based therapy in patients with advanced gastric cancer.
  
  
  METHODS
  An adequate literature search in EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) was conducted. Phase II or III randomized controlled trials (RCTs) that compared effectiveness and safety between oxaliplatin-based and cisplatin-based therapy in patients with advanced gastric cancer were eligible. The primary endpoint was overall response rate (ORR), progression free survival (PFS) and overall survival (OS). The second endpoint was the adverse events.
  
  
  RESULTS
  Five phase II or III RCTs involving a total of 2,046 patients were identified. The results showed that there were no significant difference in ORR (OR = 1.17, 95% CI = 0.98-1.40, p = 0.08, I2 = 0%), PFS (HR = 0.92, 95% CI = 0.84-1.01, p = 0.09, I2 = 0%) and OS (HR = 0.91, 95% CI = 0.82-1.01, p = 0.07, I2 = 0%) between oxaliplatin-based therapy and cisplatin-based therapy. In addition, oxaliplatin-based therapy had lower risk of neutropenia, anemia, nausea, alopecia, thromboembolism, stomatitis and creatinine increased at all grades, and neutropenia, anemia, leukopenia and alopecia at 3-4 grades than cisplatin-based therapy. However, oxaliplatin-based therapy was associated with increased risk of neurosensory toxicity and thrombocytopenia.
  
  
  CONCLUSIONS
  Our meta-analysis showed that there were no significant difference in ORR, PFS and OS between oxaliplatin-based therapy and cisplatin-based therapy. The oxaliplatin-based therapy could generally decrease the risk of adverse effects except neurosensory toxicity and thrombocytopenia.
authors.affiliation: Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Yongzhao
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical College and The Second People's Hospital of Huai'an, Huai'an, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Jiale
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yanna
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Zhijia
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Clinical Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
authors.forename: Qi-Long
authors.initials: QL
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Qi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D000077150:Oxaliplatin; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002945:Cisplatin
keywords: advanced gastric cancer; chemotherapy; effectiveness; safety