Acid-suppressive agents and survival outcomes in patients with cancer: a systematic review and meta-analysis

2020 ◽  
Vol 26 (1) ◽  
pp. 34-50
Author(s):  
Hyun Jin Song ◽  
Kiyon Rhew ◽  
Yoon Jae Lee ◽  
In-Hyuk Ha
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Survival Outcomes ◽  
Patients With Cancer

scholarly journals Impact of Use of Gastric-Acid Suppressants and Oral Anti-Cancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 998 ◽  
Author(s):  
Alice Indini ◽  
Fausto Petrelli ◽  
Gianluca Tomasello ◽  
Erika Rijavec ◽  
Antonio Facciorusso ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastric Acid ◽  
Solid Tumors ◽  
Fixed Effects ◽  
Negative Impact ◽  
Meta Analysis ◽  
Soft Tissue Sarcomas ◽  
Oral Chemotherapy ◽  
Survival Outcomes ◽  
Anti Cancer

We performed a systematic review and meta-analysis to evaluate the role of gastric acid suppressant use on outcomes of tyrosine kinase inhibitors (TKIs) and oral chemotherapy. We identified all research evaluating the effect of GAS (gastric acid suppressants) use on patients receiving oral chemotherapy or TKIs for solid tumors. The pooled hazard ratios (HRs) and 95% confidence interval (95%CI) for overall survival (OS) and progression-free survival (PFS) were calculated with a fixed-effects or a random effects model. The study population included n = 16 retrospective studies and 372,418 patients. The series concerned gastrointestinal tract tumors (n = 5 studies), renal cell carcinomas (RCC, n = 3 studies), non-small cell lung cancers (NSCLC, n = 5 studies), and soft tissue sarcomas or mixed histologies solid tumors in n = 3 studies. The pooled HRs for OS and PFS were 1.31 (95%CI: 1.20–1.43; p < 0.01) and 1.3 (95%CI 1.07–1.57; p < 0.01) for GAS and no GAS users, respectively. Only studies of EGFR (epidermal growth factor receptor) mutated NSCLC patients receiving TKIs and those with colorectal cancer receiving oral chemotherapy showed a significant correlation between GAS and poor survival. Our study supports the evidence of a possible negative impact of concomitant GAS therapy on survival outcomes of patients receiving oral anti-cancer drugs.

scholarly journals Correlation between PD-L1 expression ON CTCs and prognosis of patients with cancer: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 1938476
Author(s):  
Defeng Kong ◽  
Wen Zhang ◽  
Zhenrong Yang ◽  
Guoliang Li ◽  
Shujun Cheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Patients With Cancer

Use of opioids in patients with cancer with hepatic impairment—a systematic review

2021 ◽  
pp. bmjspcare-2021-003065
Author(s):  
Lewis Thomas Hughes ◽  
David Raftery ◽  
Paul Coulter ◽  
Barry Laird ◽  
Marie Fallon
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Hepatic Impairment ◽  
Evaluation System ◽  
Meta Analysis ◽  
Hepatic Function ◽  
Cochrane Central Register ◽  
Assessment Development ◽  
Patients With Cancer ◽  
Central Register

PurposeOpioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in patients with cancer with hepatic impairment.MethodsA systematic review was conducted and the following databases searched: AMED (−2021), MEDLINE (−2021), EMBASECLASSIC + EMBASE (−2021) and Cochrane Central Register of Controlled Trials (−2021). Eligible studies met the following criteria: patients with cancer-related pain, taking an opioid (as defined by the WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents); >18 years of age; patients with hepatic impairment defined using recognised or study-defined definitions; clinical outcome hepatic impairment related; and primary studies. All eligible studies were appraised using the Grading of Recommendations Assessment, Development and Evaluation system.ResultsThree studies (n=95) were eligible but heterogeneity meant meta-analysis was not possible. Each individual study focused on only one each of oxycodone±hydrocotarnine, oxycodone/naloxone and morphine. No recommendations could be formulated on the preferred opioid in patients with hepatic impairment.ConclusionsMorphine is the preferred opioid in hepatic impairment owing to clinical experience and pharmacokinetics. This review, however, found little clinical evidence to support this. Dose adjustments of morphine and the oxycodone formulations reviewed remain necessary in the absence of quality evidence. Overall, the quality of existing evidence on opioid treatments in cancer pain and hepatic impairment is low and there remains a need for high-quality clinical studies examining this.

scholarly journals Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

2021 ◽  
Author(s):  
Yueling Zhou ◽  
Ping Wen ◽  
Yue Yu ◽  
Zhenyi Yang ◽  
Yixuan Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Early Stage ◽  
Meta Analysis ◽  
Small Cell ◽  
Survival Outcomes ◽  
Small Cell Lung ◽  
Early Stage Nsclc

Abstract Background: Stereotactic body radiation therapy (SBRT) is considered as the preferred treatment method for inoperable early-stage non-small cell lung cancer (NSCLC). However, there is still a debate on the efficacy of SBRT and surgery. This meta-analysis aimed to compare survival outcomes of SBRT and surgery for early-stage NSCLC (≤5cm).Methods: A systematic review and meta-analysis were performed to compare survival outcomes of surgery and SBRT. And the pooled analysis was conducted with STATA 14.0 software. Results: Thirty-nine comparative studies were included for systematic review and twenty-eight of which for quantitative analysis. Compared with SBRT, overall survival (OS) was superior after surgical resection, included lobectomy, sublobar resection, video-assisted thoracoscopic surgery, and thoracotomy, for patients with early-stage NSCLC (≤5cm). And the results of subgroup analysis remained the support of surgery except for the OS of operable matched cohorts and the one matched cohort of age ≥75. However, the HR of OS showed a reduction from patients with unspecific age, ≥65 to ≥75 years old and histopathologically confirmed NSCLC to clinical NSCLC. Although cancer-specific survival and local control was superior after surgery, the recurrence rate of tumors, locoregional control, distant control, and regional control of matched patients demonstrated no significantly different outcomes between SBRT and surgery for early-stage NSCLC.Conclusions: Results show that surgery has superior OS, CSS and local control compared to SBRT for early-stage NSCLC. There is still necessary to explore the survival difference between SBRT and surgery for patients with different characteristics by large-sample, long-term follow-up randomized clinical studies.

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