scholarly journals Better survival of patients with oligo- compared with polymetastatic cancers:  a systematic review and meta-analysis of 173 studies

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 423
Author(s):  
Fausto Petrelli ◽  
Antonio Ghidini ◽  
Michele Ghidini ◽  
Roberta Bukovec ◽  
Francesca Trevisan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
Modern Concept ◽  
Cochrane Library ◽  
Published Data ◽  
Patients With Cancer ◽  
Risk Of Death ◽  
The Cochrane Library

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data.  Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI).  The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients.  Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better OS (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively.  Conclusions. Patients with oligometastases have a significantly better prognosis than those with more widespread stage IV tumors. We suggest that a treatment strategy that involves bot the primary and the metastases should be identified at the time of diagnosis.

scholarly journals Better survival of patients with oligo- compared with polymetastatic cancers:  a systematic review and meta-analysis of 173 studies

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 423
Author(s):  
Fausto Petrelli ◽  
Antonio Ghidini ◽  
Michele Ghidini ◽  
Roberta Bukovec ◽  
Francesca Trevisan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
Modern Concept ◽  
Cochrane Library ◽  
Published Data ◽  
Risk Of Death ◽  
Personalized Approach ◽  
The Cochrane Library

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data.  Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI).  The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients.  Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better overall survival (OS) (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively. Biliary tract and cervical cancer do not significantly better in OM stage likely for paucity of data. Conclusions. Patients with OM cancers have a significantly better prognosis than those with more widespread stage IV tumors. In OM cancer patients a personalized approach should be pursued.

scholarly journals Better survival of patients with oligo- compared with polymetastatic cancers:  a systematic review and meta-analysis of 173 studies

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 423
Author(s):  
Fausto Petrelli ◽  
Antonio Ghidini ◽  
Michele Ghidini ◽  
Roberta Bukovec ◽  
Francesca Trevisan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
Modern Concept ◽  
Cochrane Library ◽  
Published Data ◽  
Risk Of Death ◽  
Personalized Approach ◽  
The Cochrane Library

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data.  Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI).  The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients.  Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better overall survival (OS) (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively. Biliary tract and cervical cancer do not significantly better in OM stage likely for paucity of data. Conclusions. Patients with oligometastases have a significantly better prognosis than those with more widespread stage IV tumors. In OM cancer patients a personalized approach should be pursued.

scholarly journals Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1458 ◽  
Author(s):  
Fausto Petrelli ◽  
Alessandro Iaculli ◽  
Diego Signorelli ◽  
Antonio Ghidini ◽  
Lorenzo Dottorini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Free Survival ◽  
Patients With Cancer ◽  
Hazard Ratios ◽  
The Cochrane Library ◽  
Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

scholarly journals Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Fausto Petrelli ◽  
Alessandro Iaculli ◽  
Diego Signorelli ◽  
Antonio Ghidini ◽  
Lorenzo Dottorini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Free Survival ◽  
Patients With Cancer ◽  
Hazard Ratios ◽  
The Cochrane Library ◽  
Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumors treated with ICIs. PubMed, the Cochrane Library, and Embase were searched from inception until September 2019 for observational or prospective studies reporting prognosis of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI), and an HR &gt; 1 associated with a worse outcome in ABs users compared to no-ABs users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51&ndash;2.84; P&lt;.01). Similarly, PFS was inferior in ABs users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22&ndash;1.93; p&lt;.01). In cancer patients treated with ICIs, AB use significantly reduces OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

scholarly journals Prognostic and clinicopathological significance of systemic immune-inflammation index in colorectal cancer: a meta-analysis

2020 ◽  
Vol 12 ◽  
pp. 175883592093742 ◽  
Author(s):  
Meilian Dong ◽  
Yonggang Shi ◽  
Jing Yang ◽  
Quanbo Zhou ◽  
Yugui Lian ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Cochrane Library ◽  
Hazard Ratios ◽  
Clinicopathological Significance ◽  
Immune Inflammation ◽  
Ecog Ps ◽  
The Cochrane Library

Background: Previous studies on the systemic immune-inflammation index (SII), which is based on platelet, neutrophil and lymphocyte counts, as a prognostic marker in patients with colorectal cancer (CRC) yielded inconsistent results. The aim of this study was to evaluate the prognostic and clinicopathological role of SII in CRC via meta-analysis. Methods: A comprehensive literature survey was performed on PubMed, Web of Science, Embase and the Cochrane Library databases to include studies published up to 6 April 2020. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were computed to estimate the prognostic and clinicopathological value of SII in CRC. Results: A total of 12 studies published between 2016 and 2019 were included in our meta-analysis. The combined analysis showed that high SII levels were significantly associated with worse overall survival (OS; HR = 1.61, 95% CI = 1.21–2.13, p = 0.001) and progression-free survival (HR = 1.74, 95% CI = 1.26–2.39, p = 0.001) in CRC. Moreover, elevated SII was also correlated with poor tumor differentiation (OR = 1.60, 95% CI = 1.27–2.02, p < 0.001), presence of distant metastasis (OR = 2.27, 95% CI = 1.10–4.67, p = 0.026), ECOG PS of 1–2 (OR = 1.98, 95% CI = 1.39–2.84, p < 0.001) and tumor size ⩾5 cm (OR = 1.49, 95% CI = 1.18–1.88, p = 0.001). However, high SII was not significantly associated with sex, tumor location, lymph node metastasis, or age in patients with CRC. Conclusion: Our meta-analysis indicated that high SII levels predicted poor prognosis in CRC. In addition, an elevated SII was also associated with clinical factors, implying higher malignancy of the disease.

scholarly journals Effectiveness of Lomustine Combined With Bevacizumab in Glioblastoma: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xing Ren ◽  
Di Ai ◽  
Tong Li ◽  
Lei Xia ◽  
Lingzhi Sun
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Control Group ◽  
Subgroup Analyses ◽  
Group A ◽  
Group 2 ◽  
The Cochrane Library

Introduction: Despite surgical and chemotherapeutical treatment options, the prognosis for glioblastoma (GBM) remains poor. Some studies have found that using lomustine plus bevacizumab to treat GBM can prolong overall survival (OS) and progression-free survival (PFS). The aim of this study was to explore the efficacy of the two drugs in combination treatment of GBM using a meta-analysis of the existing literature to help settle the ongoing debate.Materials and Methods: PubMed, EMBASE, and the Cochrane Library were searched for the effectiveness of lomustine plus bevacizumab in GBM literature, updated on June 6, 2020. The main outcomes analyzed included PFS and OS; the effects of this drug combination on the 6-month PFS, which represents the percentage of patients who had PFS for 6 months, were also analyzed. All the data were pooled: OS and PFS with the mean difference (MD) and 6-month PFS with the risk ratio (RR). Because there were different control groups and dose groups, two subgroup analyses were run to ensure they were comparable. All statistical analyses were performed using the Review Manager Version 5.3 software.Results: Six clinical trials were identified which included 1,095 patients (treatment group: 516; control group: 579). The group treated with lomustine and bevacizumab showed an improvement in OS (MD =1.37; 95% CI, 0.49–2.25; p = 0.002), PFS (MD = 0.23; 95% CI, 0.13–0.34; p &lt; 0.00001), and 6-month PFS (RR = 2.29; 95% CI, 1.43–3.65; p = 0.0005). Two subgroup analyses of the main outcome, OS, show that the results of Control group A (p = 0.01) and Dose group 2 (p = 0.003) are significantly different from those of the other control or dose groups.Conclusion: This study shows that lomustine and bevacizumab can effectively increase OS, PFS, and 6-month PFS in patients with GBM. The encouraging results of the lomustine and bevacizumab combination therapy for GBM should be studied in more clinical trials in the future.

Risk of Suicide Mortality Among Cancer Patients: A Meta-Analysis of Observational Studies

2017 ◽  
Vol 41 (S1) ◽  
pp. S290-S291 ◽  
Author(s):  
R. Calati ◽  
V. Di Mattei ◽  
P. Courtet
Keyword(s):  
Suicide Risk ◽  
Meta Analysis ◽  
Suicide Mortality ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Patients With Cancer ◽  
Competing Interest ◽  
Trim And Fill ◽  
Meta Analyses ◽  
The Cochrane Library

IntroductionSuicide rates among patients with cancer are higher than ones in the general population.ObjectiveThis meta-analysis aims to estimate the suicide risk in patients with cancer.MethodsWe searched Medline, PsycINFO, and the Cochrane library to identify articles published before July 1, 2016, examining the association between suicide [death (SD), attempt (SA), ideation (SI)] and any form of diagnosed cancer.ResultsWe initially identified 4880 records and after unsuitable studies were removed, our search yielded 102 publications of which 14 were used in the meta-analyses. Patients with cancer had higher risk of SD (seven studies, 247.869 participants; odds ratio [OR] = 1.52, 95% CI = 1.22–1.89, P = 0.0002) compared with those without cancer (among case-control studies focused on SD versus living controls). Among studies focused on SD versus other deaths, patients with cancer had higher risk of SD (two studies, 23.839 participants; OR = 1.53, 95% CI = 1.03–2.27, P = 0.03). No difference has been detected for risk of SA (four studies, 8.147.762 participants) and for SI (two studies, 37.879 participants).Since publication bias was detected, the “trim and fill” method was applied. The majority of the included studies have a high quality at the STROBE statement.ConclusionThe assessment of suicide risk in this population is crucial.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Higher Tumor Mutation Burden Was a Predictor for Better Outcome for NSCLC Patients Treated with PD-1 Antibodies: A Systematic Review and Meta-analysis

2021 ◽  
pp. 247263032110245
Author(s):  
Yuhui Zheng ◽  
Meihong Yao ◽  
Yinghong Yang
Keyword(s):  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Small Cell Lung ◽  
Free Survival ◽  
Tumor Mutation Burden ◽  
Ovid Medline ◽  
Mutation Burden ◽  
The Cochrane Library ◽  
Nsclc Patients

This study was conducted to evaluate the predictive efficacy of tumor mutation burden (TMB) in patients with non–small-cell lung cancer (NSCLC) receiving PD-1 antibodies. Embase, PubMed, Ovid Medline, and the Cochrane Library were systematically searched until May 24, 2020. The keywords included “PD-1,” “TMB,” and “NSCLC.” Overall survival (OS) and progression-free survival (PFS) were summarized and combined using the hazard ratio (HR) and 95% confidence interval. Twenty-one studies with 9883 patients were included in the meta-analysis. The overall relapse rate ranged from 39.3% to 64.3% in the higher TMB group as compared with 0% to 40% in the lower TMB group. The median OS ranged from 2.9 to 23 mo in the higher TMB group as compared with 4.3 to 16.2 mo in the lower TMB group. Patients with a higher TMB had a better OS as compared with patients with a lower TMB (HR = 0.61, P < 0.001). Similarly, a higher TMB was also a good predictor of PFS in patients treated with PD1/PDL1 antibodies (HR = 0.55, P < 0.001). Our results suggest that among NSCLC patients receiving PD1/PDL1 antibodies, patients with higher TMB could have a better survival outcome.

scholarly journals Efficacy and Safety of Anti-HER2 Agents in Combination With Chemotherapy for Metastatic HER2-Positive Breast Cancer Patient: A Network Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaohui Zhang ◽  
Junsheng Leng ◽  
Yidong Zhou ◽  
Feng Mao ◽  
Yan Lin ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Objective Response ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Breast Cancers ◽  
First Line ◽  
Her2 Positive ◽  
The Cochrane Library

BackgroundThe presence of anti-HER2 agents, such as trastuzumab, pertuzumab, and trastuzumab emtansine (T-DM1), significantly improved the prognosis of metastatic HER2-positive (HER2+) breast cancers (BC). However, drug resistance and disease progression are still common. In order to further improve the treatment efficacy, new clinical trials about anti-HER2 agents in combination with chemotherapy are growing rapidly. We conducted the network meta-analysis to synthesize evidences of clinical trials to identify the best therapy for metastatic HER2+ BC.MethodsA systematic search of randomized controlled trials regarding anti-HER2 agents in combination with chemotherapy for advanced or metastatic breast cancers up to May 2020 was conducted in Embase, PubMed, and the Cochrane Library. The primary outcome was progression-free survival (PFS). The secondary outcomes were overall survival (OS), objective response rate (ORR), and safety. Bayesian network meta-analysis was conducted to synthesize the results and rank the therapies.ResultsTwenty-six studies, including 16 studies for first-line treatments and 10 studies for second- or later-line treatments were included in the network meta-analysis. For first-line studies, the THP (taxanes + trastuzumab + pertuzumab) regimen exhibited the highest probability to be the optimal treatment in all efficacy outcomes and moderate safety. For second- or later-line studies, the T-DM1 and XHTuC (capecitabine + trastuzumab + tucatinib) regimens ranked top two in all efficacy outcomes according to the surface under the cumulative ranking (SUCRA) results. T-DM1 ranked first in PFS and OS whereas XHTuC ranked first in ORR. The safety outcomes of T-DM1 and XHTuC were acceptable.ConclusionsTHP was still the optimal first-line treatment for metastatic HER2+ BC. T-DM1 and XHTuC were recommended for second-line treatments.Systematic Review RegistrationINPLASY.com, identifier (INPLASY202090086).

scholarly journals Prognostic Role of MicroRNA-126 for Survival in Malignant Tumors: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jie Bu ◽  
Hui Li ◽  
Xiao-yang Li ◽  
Li-hong Liu ◽  
Wei Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Malignant Tumors ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Prognostic Role ◽  
Patients With Cancer ◽  
Hazard Ratios ◽  
High Level ◽  
The Cochrane Library

Background.Increasing studies found that miR-126 expression may be associated with the prognosis of cancers. Here, we performed a meta-analysis to assess the prognostic role of miR-126 in different cancers.Methods.Eligible studies were identified by searching in PubMed, Embase, the Cochrane Library, CNKI, and Wan Fang databases up to March 2015. Pooled hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated to investigate the correlation between miR-126 and survival of cancers.Results.Thirty studies including a total of 4497 participants were enrolled in this meta-analysis. The pooled results showed that high level of miR-126 was a predictor for favorable survival of carcinomas, with pooled HR of 0.77 (95% CI 0.64–0.93) for OS, 0.64 (95%CI 0.48–0.85) for DFS, and 0.70 (95% CI 0.50–0.98) for PFS/RFS/DSS. However, high level of circulating miR-126 predicted a significantly worse OS in patients with cancer (HR = 1.65, 95% CI 1.09–2.51).Conclusions.Our results indicated that miR-126 could act as a significant biomarker in the prognosis of various cancers.

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