Systematic Evaluation Of The Safety And Efficacy Of Gemcitabine Combined With Molecular Targeted Agents And Platinum Based Drugs In The Treatment Of Patients With Advanced Pancreatic Cancer

Objective: The safety and effectiveness of Molecular(GEM)combined with targeted drugs(MTD)and drugs Platinum(PD)in the treatment of advanced pancreatic cancer were analyzed by Meta analysis.Method: PubMed the Cochrane Library,EMBASE,China National Knowledge Infrastructure(CNKI),China Wanfang database,Chinese biomedical literature database of computer retrieval,find the relevant literature from the database to 2015 in July 31,at home and abroad have been published.The treatment group was a GEM combined molecular targeted drugs such as erlotinib erlotinib,Marseille for Nepal,ASIM for Nepal,sorafenib and bevacizumab,cetuximab and for imidacloprid Pennsylvania)or in combination with platinum chemotherapy,control group for GEM monotherapy or combination with placebo chemotherapy in the treatment of middle and late stage pancreatic cancer: a randomized controlled trial.The two reviewers independently retrieved and collected data.According to the inclusion criteria,the major indexes were survival(including overall survival and disease progression free survival).The secondary analysis included objective response rate,disease control rate and adverse reaction(including gastrointestinal reaction and hematologic response).Result:1 A randomized controlled trial of GEM combined with molecular targeted agents,a total of 11.After systematic review and Meta analysis,we showed that GEM combined with molecular targeted drug chemotherapy could increased the disease control(OR=1.23,95% CI=[1.07,1.41],P=0.004<0.01).But in Object Response Rate,adverse drug act had significanteffect on difference,Neutrophilic granulocytopenia was increased(OR=1.20,95% CI=[1.04,1.40],P=0.01)? gastrointestinal reaction was increased(OR=1.26,95% CI=[1.07,1.48],P=0.005).2 A randomized controlled trial of GEM combined with platinum,a total of 11.After systematic review and Meta analysis,we showed that GEM combined with platinum chemotherapy had significant effect on difference disease control rate(OR = 1.63,P=0.0005<0.0)and Object Response Rate(OR=1.48,P = 0.006<0.01).On the same time,adverse drug act had significant effect on difference,Thrombocytopenia was increased(P=0.02)?gastrointestinal reaction was increased(P=0.0002).Conclusion:1 GEM combined with MTD can improve the disease control rate with GEM alone.Although the adverse drug reactions of neutrophilic and gastrointestinal was increased significantly,the chemotherapy effect had been increased significantly.2 GEM combined with PD can improve the chemotherapy effect and increase the object response rate with GEM alone.Although the adverse drug reactions was increased significantly,especially thrombocytopenia,anemia and gastrointestinal.