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Efficacy and safety of palliative chemotherapy for patients with advanced breast cancer pretreated with anthracyclines and taxanes: a systematic review

No standard monotherapy or combination palliative chemotherapy currently exists for patients with advanced breast cancer pretreated with anthracyclines and taxanes. In this systematic review we assess the current knowledge on the efficacy and safety of palliative single-agent chemotherapy drugs--capecitabine, vinorelbine, gemcitabine, and liposomal doxorubicin--commonly used in daily clinical practice. We identified 22 studies, of which ten investigated capecitabine, nine investigated vinorelbine, three investigated gemcitabine, and one investigated liposomal doxorubicin. The greatest amount of information was available for capecitabine and vinorelbine. These two drugs showed good efficacy. The disease control rate differed significantly between the four drugs, which is relevant in terms of how well tumour symptoms can be improved and whether quality of life can be maintained or even improved. To obtain more evidence of the efficacy and safety of chemotherapeutic agents used in this pretreated population of advanced breast cancer patients, randomised comparisons of the various drugs, as monotherapy and in combination with targeted agents, are needed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Should chemotherapy combinations for advanced non-small cell lung cancer be platinum-based: a meta-analysis of phase III randomized trials

BACKGROUND: Non-platinum regimens have been proposed as an alternative to the platinum-based combinations for treatment of advanced non-small cell lung cancer. However, conflicting results were reported.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Efficacy and safety of rh-endostatin combined with chemotherapy versus chemotherapy alone for advanced NSCLC: a meta-analysis review

BACKGROUND AND OBJECTIVE: In recent years, there has been a large number of studies and reports about the efficacy and safety of recombinant human endostatin (rh-endostatin), an anti-angiogenic drug, in treatment of advanced lung cancer. Authentic assessment of rh-endostatin treatment in lung cancer is important. The aim of this study is to assess the clinical efficacy and safety of rh-endostatin combined with chemotherapy in the treatment of patients with non-small cell lung cancer (NSCLC).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Kanglaite for treating advanced non-small-cell lung cancer: a systematic review

BACKGROUND: In the past years, many reports on Kanglaite were publicated in China, researchers across the country. The aim of this study is to review the effectiveness and safety of Kanglaite for treating advanced non-small-cell lung cancer.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Non-hormonal systemic therapy in men with metastatic hormone-refractory prostate cancer: a clinical practice guideline

BACKGROUND: Prostate cancer that has recurred after local therapy or disseminated distantly is usually treated with androgen deprivation therapy; however, most men will eventually experience disease progression within 12 to 20 months. New data emerging from randomized controlled trials (RCTs) of chemotherapy provided the impetus for a systematic review addressing the following question: which non-hormonal systemic therapies are most beneficial for the treatment of men with hormone-refractory prostate cancer (HRPC) and clinical evidence of metastases?

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Comparison of the efficacy and safety of single-agent and doublet chemotherapy in advanced non-small cell lung cancer in the elderly: a meta-analysis

BACKGROUND: In patients with advanced non-small cell lung cancer (NSCLC) aged more than 70 years, the benefit-to-risk ratio of doublet chemotherapy vs single-agent is not established.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Association between class III beta-tubulin expression and response to paclitaxel/vinorebine-based chemotherapy for non-small cell lung cancer: a meta-analysis

BACKGROUND: It has been proposed that the level of class III β-tubulin gene expression can be used to predict clinical sensitivity to paclitaxel/vinorebine-based chemotherapy in non-small cell lung cancer (NSCLC) patients. However, whereas there are published reports supporting this association, there are also reports of studies that failed to find such an association. We conducted a meta-analysis of all relevant published data to provide a combined statistical assessment of the proposed association of expression variations of class III β-tubulin with objective response and median survival in patients with NSCLC treated with paclitaxel/vinorebine-based chemotherapy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The clinical effectiveness and cost-effectiveness of gemcitabine for metastatic breast cancer: a systematic review and economic evaluation

OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of gemcitabine, used in combination with paclitaxel, as a second-line treatment for people with metastatic breast cancer who have relapsed following treatment with anthracycline-based chemotherapy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Clinical effectiveness and cost-effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic non-small cell lung cancer: a systematic review and economic evaluation

BACKGROUND: The National Institute for Health and Care Excellence (NICE) has issued multiple guidance for the first-line management of patients with lung cancer and recommends different combinations of chemotherapy treatments. This review provides a synthesis of clinical effectiveness and cost-effectiveness evidence supporting current guidance.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Endostar combined with chemotherapy versus chemotherapy alone for advanced NSCLCs: a meta-analysis

The authors concluded that recombinant human endostatin combined with platinum-based chemotherapy can improve response rate without increasing side effects in patients with advanced non-small cell lung cancer. The authors' conclusions reflect the findings for vinorelbine plus cisplatin in combination with recombinant human endostatin but insufficient evidence on other combination therapies means their reliability is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The clinical efficacy of cytotoxic agents in locally advanced or metastatic breast cancer patients pretreated with an anthracycline and a taxane: a systematic review

The review found that evidence was extremely limited on the efficacy of chemotherapy regimens currently available in Europe for women with locally advanced or metastatic breast cancer previously treated with a taxane and anthracycline. Although there was some possibility that foreign language studies were missed, the review was well conducted in most respects and the authors’ cautious conclusions appear reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Combination of chemotherapy without platinum compounds in the treatment of advanced non-small cell lung cancer: a systematic review of phase III trials

This review concluded that there was insufficient evidence to draw firm conclusions about the equivalence of or differences between non-platinum and platinum-based doublet regimens for patients with non-small-cell lung cancer. Considering the limitations of the review, the authors' conservative conclusions seem appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Second-line treatment for advanced non-small cell lung cancer: a systematic review

This review assessed the effects of second-line treatments for advanced non-small-cell lung cancer. The authors concluded that second-line chemotherapy can produce a small but significant survival advantage, but further research is required. The lack of a quality assessment and the lack of supporting data for some outcomes mean that the reliability of the authors' conclusions about efficacy is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Systematic review of the clinical effectiveness and cost-effectiveness of capecitabine (Xeloda) for locally advanced and/or metastic breast cancer

This review concluded that capecitabine combination therapy for breast cancer was more effective (and likely to be cost-effective) than single-agent docetaxel, but was associated with higher incidences of adverse effects. More randomised controlled trials (RCTs) on capecitabine monotherapy were needed as no conclusions could be drawn on its therapeutic benefit from available evidence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Taxanes as first-line therapy for advanced non-small cell lung cancer: a systematic review and practice guideline

This review assessed the use of taxanes as first-line chemotherapy for patients with advanced non-small-cell lung cancer. The authors concluded that taxane-cisplatin was effective as first-line treatment, whereas taxane-gemcitabine could be considered in the case of contraindication to platinum agents. The review had some methodological weaknesses but the authors' conclusions appear appropriate and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Use of trastuzumab in HER2-positive metastatic breast cancer beyond disease progression: a systematic review of published studies

This review investigated the efficacy of trastuzumab-based treatments beyond progression in HER2-positive metastatic breast cancer and found that trastuzumab-based regimens might have a role and well-designed phase III trials were needed. The authors' conclusions are cautious, but given the limitations (particularly the inclusion of observational studies and only one RCT) these conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Impact of third-generation drugs on the activity of first-line chemotherapy in advanced non-small cell lung cancer: a meta-analytical approach

The authors concluded that the third-generation regimens had comparable response rates for chemotherapy-naive patients with advanced non-small cell lung cancer, but produced different rates of disease control. These conclusions appear to reflect the findings, but a lack of reporting of the review methods and no assessment of trial quality make it difficult to confirm their reliability.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

A systematic review of quality of life associated with standard chemotherapy regimens for advanced non-small cell lung cancer

This review assessed methods and results of quality of life measures used in trials of chemotherapy for non-small cell lung cancer and concluded that there was room for improvement in quality of life research and toxicity reporting, but no major differences in quality of life between regimens. The authors' conclusions appear reliable but were limited by the poor literature search.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Multiple-treatments meta-analysis of chemotherapy and targeted therapies in advanced breast cancer

This review concluded that there were many options for first and subsequent lines of therapy, including chemotherapy and targeted therapies, that have comparable efficacy in advanced breast cancer. Overall, the authors' conclusions appear valid, but the lack of any assessment of trial quality and the use of both direct and indirect evidence, suggests that the findings should be interpreted cautiously.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Efficacy and side effects of cisplatin- and carboplatin-based doublet chemotherapeutic regimens versus non-platinum-based doublet chemotherapeutic regimens as first line treatment of metastatic non-small cell lung carcinoma: a systematic review of randomized controlled trials

This review concluded that cisplatin-based, but not carboplatin-based, doublet regimens were associated with slightly better survival and had different side effects compared with non-platinum based doublet regimens in the first-line treatment of non-small cell lung cancer. These conclusions did not acknowledge that there were no significant differences for most outcomes assessed and should be interpreted with some caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

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