Meta-analysis of gemcitabine and cisplatin combination chemotherapy versus gemcitabine alone for pancreatic cancer.

Purpose: The aim of this study is to assess the efficacy and safety of combination chemotherapy with gemcitabine (GEM) and cisplatin (CIS) compared with GEM alone in patients with pancreatic cancer.

Methods: A computerized search through electronic databases, including PubMed (until February 2016), was performed to obtain eligible randomized controlled trials that compared effectiveness of GEM and CIS combination chemotherapy with GEM alone in patients with pancreatic cancer. The indicators we used were overall response rate, stable disease rate, progressive disease rate, and 1-year overall survival. Relative risk and 95% confidence interval were calculated and pooled using a fixed effects model.

Results: Compared with GEM alone, combination chemotherapy has significant advantage in the overall response rate (odds ratio [OR] =0.52, P = 0.004), stable disease (OR = 0.68, P = 0.05), and progressive disease (OR = 2.11, P = 0.0002). However, the control group and experimental group have no significant difference in 1-year survival (OR = 1.07, P = 0.75). The combination chemotherapy with GEM and CIS group had higher hematological toxicities including neutropenia (OR = 0.39, P = 0.0003), thrombocytopenia (OR = 0.3, P < 0.0001), and anemia (OR = 0.41, P = 0.004).

Conclusions: Overall response rate, stable disease, and progressive disease, as well as 1-year survival rate in patients who received GEM + CIS, were superior to those treated with GEM alone. Combination chemotherapy with GEM and CIS may offer greater benefits in the treatment of pancreatic cancer than that of GEM alone although the combination group had higher hematological toxicities.