Cargando…

The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies

PURPOSE: Fluoropyrimidine plus platinum (FP) is currently the standard treatment for esophageal cancer (EC). In recent years, taxane-based chemotherapy has also been used and has shown good efficacy in EC. This study aims to investigate the advantages of taxane-based over FP chemotherapy, as well as...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Tao, Yu, Jie, Liu, Min, Chen, Yanliang, Zhu, Caiyun, Lu, Lin, Wang, Mingzhu, Min, Lingfeng, Liu, Xinxin, Zhang, Xizhi, Gubat, Johannes A, Chen, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368118/
https://www.ncbi.nlm.nih.gov/pubmed/30787595
http://dx.doi.org/10.2147/DDDT.S189514
_version_ 1783393926640566272
author Wang, Tao
Yu, Jie
Liu, Min
Chen, Yanliang
Zhu, Caiyun
Lu, Lin
Wang, Mingzhu
Min, Lingfeng
Liu, Xinxin
Zhang, Xizhi
Gubat, Johannes A
Chen, Yong
author_facet Wang, Tao
Yu, Jie
Liu, Min
Chen, Yanliang
Zhu, Caiyun
Lu, Lin
Wang, Mingzhu
Min, Lingfeng
Liu, Xinxin
Zhang, Xizhi
Gubat, Johannes A
Chen, Yong
author_sort Wang, Tao
collection PubMed
description PURPOSE: Fluoropyrimidine plus platinum (FP) is currently the standard treatment for esophageal cancer (EC). In recent years, taxane-based chemotherapy has also been used and has shown good efficacy in EC. This study aims to investigate the advantages of taxane-based over FP chemotherapy, as well as discuss its drawbacks, in the treatment of EC. PATIENTS AND METHODS: A literature search was done for studies comparing clinical outcomes between taxane-based and FP chemotherapy in EC. Pooled analyses were performed to compare the efficacy and grade 3/4 adverse events in patients who received neoadjuvant chemotherapy (NACT), neoadjuvant chemoradiotherapy (NACRT), or definitive chemoradiotherapy (dCRT). Subgroup analyses were also conducted in esophageal squamous cell carcinoma (ESCC). RESULTS: Thirty-one studies with a total of 3,912 patients were included in the analysis. Better long-term survival was found in patients who received taxane-based NACT (progression-free survival (PFS): pooled HR=0.58, P=0.0008; and overall survival (OS): pooled HR=0.50, P<0.00001) and dCRT (PFS: pooled HR=0.75, P<0.0001). In NACRT, taxane-based treatment and FP showed similar efficacy. In ESCC patients, taxane-based treatment showed better OS (NACT: pooled HR=0.57, P=0.02; NACRT: pooled HR=0.51, P=0.03; and dCRT: pooled HR=0.73, P<0.0001) than FP chemotherapy. Furthermore, taxane-based therapy also showed a better short-term response (complete response (CR), objective response rate (ORR), disease control rate (DCR), or pathologic complete response (pCR). However, taxane-based therapy was significantly correlated with a higher incidence of grade 3/4 leukopenia, neutropenia, and diarrhea. CONCLUSION: Compared to FP, taxane-based therapy produced better clinical response and outcomes in EC patients receiving NACT or dCRT, and in all types of therapy in patients with ESCC. Taxane-based treatment is associated with more frequent toxicity.
format Online
Article
Text
id pubmed-6368118
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-63681182019-02-20 The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies Wang, Tao Yu, Jie Liu, Min Chen, Yanliang Zhu, Caiyun Lu, Lin Wang, Mingzhu Min, Lingfeng Liu, Xinxin Zhang, Xizhi Gubat, Johannes A Chen, Yong Drug Des Devel Ther Original Research PURPOSE: Fluoropyrimidine plus platinum (FP) is currently the standard treatment for esophageal cancer (EC). In recent years, taxane-based chemotherapy has also been used and has shown good efficacy in EC. This study aims to investigate the advantages of taxane-based over FP chemotherapy, as well as discuss its drawbacks, in the treatment of EC. PATIENTS AND METHODS: A literature search was done for studies comparing clinical outcomes between taxane-based and FP chemotherapy in EC. Pooled analyses were performed to compare the efficacy and grade 3/4 adverse events in patients who received neoadjuvant chemotherapy (NACT), neoadjuvant chemoradiotherapy (NACRT), or definitive chemoradiotherapy (dCRT). Subgroup analyses were also conducted in esophageal squamous cell carcinoma (ESCC). RESULTS: Thirty-one studies with a total of 3,912 patients were included in the analysis. Better long-term survival was found in patients who received taxane-based NACT (progression-free survival (PFS): pooled HR=0.58, P=0.0008; and overall survival (OS): pooled HR=0.50, P<0.00001) and dCRT (PFS: pooled HR=0.75, P<0.0001). In NACRT, taxane-based treatment and FP showed similar efficacy. In ESCC patients, taxane-based treatment showed better OS (NACT: pooled HR=0.57, P=0.02; NACRT: pooled HR=0.51, P=0.03; and dCRT: pooled HR=0.73, P<0.0001) than FP chemotherapy. Furthermore, taxane-based therapy also showed a better short-term response (complete response (CR), objective response rate (ORR), disease control rate (DCR), or pathologic complete response (pCR). However, taxane-based therapy was significantly correlated with a higher incidence of grade 3/4 leukopenia, neutropenia, and diarrhea. CONCLUSION: Compared to FP, taxane-based therapy produced better clinical response and outcomes in EC patients receiving NACT or dCRT, and in all types of therapy in patients with ESCC. Taxane-based treatment is associated with more frequent toxicity. Dove Medical Press 2019-02-05 /pmc/articles/PMC6368118/ /pubmed/30787595 http://dx.doi.org/10.2147/DDDT.S189514 Text en © 2019 Wang et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Wang, Tao
Yu, Jie
Liu, Min
Chen, Yanliang
Zhu, Caiyun
Lu, Lin
Wang, Mingzhu
Min, Lingfeng
Liu, Xinxin
Zhang, Xizhi
Gubat, Johannes A
Chen, Yong
The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies
title The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies
title_full The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies
title_fullStr The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies
title_full_unstemmed The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies
title_short The benefit of taxane-based therapies over fluoropyrimidine plus platinum (FP) in the treatment of esophageal cancer: a meta-analysis of clinical studies
title_sort benefit of taxane-based therapies over fluoropyrimidine plus platinum (fp) in the treatment of esophageal cancer: a meta-analysis of clinical studies
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368118/
https://www.ncbi.nlm.nih.gov/pubmed/30787595
http://dx.doi.org/10.2147/DDDT.S189514
work_keys_str_mv AT wangtao thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT yujie thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT liumin thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT chenyanliang thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT zhucaiyun thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT lulin thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT wangmingzhu thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT minlingfeng thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT liuxinxin thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT zhangxizhi thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT gubatjohannesa thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT chenyong thebenefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT wangtao benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT yujie benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT liumin benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT chenyanliang benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT zhucaiyun benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT lulin benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT wangmingzhu benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT minlingfeng benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT liuxinxin benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT zhangxizhi benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT gubatjohannesa benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies
AT chenyong benefitoftaxanebasedtherapiesoverfluoropyrimidineplusplatinumfpinthetreatmentofesophagealcancerametaanalysisofclinicalstudies