The relative efficacy and safety of targeted agents used in combination with chemotherapy in treating patients with untreated advanced gastric cancer: a network meta-analysis

// Shuping Xie 1, * , Huixiang Zhang 2, * , Xueyan Wang 1 , Quanxing Ge 1 , Junhong Hu 3 1 Department of Gastroenterology, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China 2 Department of Radiotherapy, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China 3 Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, 475000, China * These authors contributed equally to this work Correspondence to: Junhong Hu, email: tangyinhuatyh@126.com Keywords: gastric cancer, targeted therapy, efficacy and safety, network meta-analysis Received: November 10, 2016      Accepted: February 15, 2017      Published: March 06, 2017 ABSTRACT Gastric cancer is one of the leading mortal causes. Targeted therapy is a new type of cancer treatment, which precisely identifies and attacks cancer cells and significantly reduces side effects. In this network meta-analysis, we focused on the efficacy and safety of 12 targeted agents on gastric cancer among a total of 8,405 patients from 24 trials. Hazard ratio (HR) with 95% credible interval (CrI) were calculated for primary outcomes, including overall survival (OS) and progression-free survival (PFS), while odds ratio (OR) with 95% CrI were calculated for secondary outcomes. Surface under the cumulative ranking curve (SUCRA) were calculated to illustrate the rank probability of various agents for different outcomes. Compared with other analyzed treatments, ramucirumab is outstanding in survival outcomes. However, higher risk of hematological events should be noted during its application. Lapatinib is also efficacious in progression reduction, while it is always combined with severe gastrointestinal events. Trastuzumab is proposed for its high efficacy in improving survival rate and safety, which is proper for most patients. In conclusion, trastuzumab was recommended as the optimal targeted agent combined with chemotherapy for gastric cancer patients.