| Abstract: | OBJECTIVES: To compare the therapeutic effects of gemcitabine (GEM) monotherapy with GEM‐cisplatin (DDP) combination chemotherapy in patients with advanced stage pancreatic cancer (APCa) through meta‐analysis. METHODS: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM‐DDP combination chemotherapy and GEM alone in APCa. A quantitative meta‐analysis using updated information based on inclusion criteria from all available RCTs was carried out by two reviewers. The primary meta‐analysis involved the overall survival (OS), objective remission rate (ORR) and toxicity. RESULTS: The meta‐analysis included six RCTs. There was no significant advantage for the GEM‐DDP combination group in 6‐month survival rate (P = 0.24) or clinical benefit rate (P = 0.58). There was a marginal significant improvement for the GEM‐DDP combination group in ORR (RD = 6%, P = 0.05; RD, risk difference = risk in the GEM‐DDP combination group – risk in the GEM alone group). Moreover, there was a significant improvement for the combination group in 6‐month TTP/TTF (RD = 9%, P = 0.02). WHO grade 3–4 toxicity was higher for the GEM‐DDP combination group in terms of neutropenia (RD = 6%, P = 0.08), thrombocytopenia (RD = 8%, P = 0.17) and vomiting/nausea (RD = 11%, P = 0.07); none reached significant difference. CONCLUSION: GEM‐DDP combination should not be recommended and GEM monotherapy remains the standard treatment for patients with APCa. |
