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Evaluation of survival benefits by platinums and taxanes for an unfavourable subset of carcinoma of unknown primary: a systematic review and meta-analysis

Cited 16 time in Web of Science Cited 19 time in Scopus
Authors
Lee, J.; Hahn, Seokyung; Kim, Dong-Wan; Kim, J.; Kang, S. N.; Rha, S. Y.; Lee, K. B.; Kang, J. -H.; Park, B. -J.
Issue Date
2013-01
Citation
British Journal of Cancer, Vol.108 No.1, pp.39-48
Keywords
carcinoma of unknown primarychemotherapymeta-analysissystematic review
Abstract
Background: Although chemotherapeutic regimens containing a taxane or platinum agent have been widely recommended for unfavourable carcinoma of unknown primary (CUP), no evidence exists for the superiority of any administered regimens. To date, the efficacy has been mostly assessed in the limited setting of phase II trials, and few attempts have been made to synthesise all available data for survival outcomes. Methods: Electronic databases were searched from 1980 to 2011. Survival results were combined for each pre-specified category of regimens using a random-effects model, and meta-regression models were used to adjust for heterogeneity in some known prognostic factors. Results: A total of 32 studies were included for meta-analysis. Tendency towards better survival outcome by platinums or taxanes was indicated. After adjustment for important prognostic factors, however, the difference between the platinum-based and non-platinum regimens became no longer significant. Survival benefits by the taxane-based regimens remained significant, with a prolonged median survival time of 1.52 months (P = 0.03) and a higher 1-year survival rate of 6.25% (P = 0.05), but the benefit did not sustain for 2 years. Conclusion: Although no effective therapies have been established, this meta-analysis helps to fill an important gap of evidence. However, caution should still be taken because of the potential unmeasured confounding.
ISSN
0007-0920
URI
https://hdl.handle.net/10371/165472
DOI
https://doi.org/10.1038/bjc.2012.516
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College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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