A network meta-analysis of eight chemotherapy regimens for treatment of advanced ovarian cancer.
This study compared the short-term efficacies of different chemotherapy regimens in the treatment of advanced ovarian cancer (AOC) through pair-wise and network meta-analyses (NMA). Randomized controlled trials (RCTs) identified in a comprehensive online literature search met our inclusion criteria. Direct and indirect evidence was combined to compare odds ratios (OR) and surfaces under the cumulative ranking curves (SUCRA) across the different treatment regimens. Twelve eligible RCTs were finally included, involving eight regimens (Paclitaxel + Carboplatin [PC], Gemcitabine + Carboplatin [GC], Carboplatin, Pegylated Liposomal Doxorubicin + Carboplatin [PLD + Carboplatin], Paclitaxel, Paclitaxel + Carboplatin + Topotecan [PC + Topotecan], Paclitaxel + Carboplatin + Epirubicin [PC + Epirubicin] and Docetaxel + Carboplatin [DC]). The NMA results revealed that in terms of overall response rate (ORR) and disease control rate (DCR), PC (ORR: OR=2.59, 95%CI=1.20-6.22; DCR: OR=2.58, 95%CI=1.05-6.82) and GC (ORR: OR=2.08, 95%CI=1.08-4.37; DCR: OR=2.43, 95%CI=1.07-5.80) were more effective against AOC than Carboplatin alone. Similarly, PC (OR=0.21, 95%CI=0.05-0.69), GC (OR=0.31, 95%CI=0.09-0.90) and PLD + Carboplatin (OR=0.22, 95%CI=0.04-0.92) slowed disease progression better than Carboplatin alone. We also found that PC was more efficacious against AOC than Carboplatin or Paclitaxel single-agent chemotherapy. Combination chemotherapy is thus recommended for AOC, and should guide subsequent drug development and treatment strategies.
Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China.
Xi-Ping
XP
Jiang
Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China.
Xiao-Hui
XH
Rui
Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China.
Cai-Xia
CX
Guo
Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China.
Ya-Qing
YQ
Huang
Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China.
Qin
Q
Li
Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China.
Yun
Y
Xu
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy*
Bayesian network model; advanced ovarian cancer; chemotherapy; combination therapy; network meta-analysis