Efficacy and safety of pharmacotherapy for cancer cachexia: A systematic review and network meta-analysis

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-09-03 DOI:10.1002/cam4.70166

Hao Chen, Masashi Ishihara, Hiroki Kazahari, Ryusuke Ochiai, Shigeru Tanzawa, Takeshi Honda, Yasuko Ichikawa, Nobuyuki Horita, Hisashi Nagai, Kiyotaka Watanabe, Nobuhiko Seki

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Abstract

Background

Cancer cachexia affects more than half of all cancer patients, reducing survival rates. Evidence-based approaches are urgently needed to optimize treatment.

Methods

A systematic review and network meta-analysis were conducted to assess the effectiveness and safety of different pharmacotherapies for cancer cachexia. Three databases (PubMed, Cochrane Library, and Web of Science) were searched for the period from January 1, 2000, to March 20, 2024. The netmeta package in R software was used to calculate the pooled effect, employing a random effects model.

Results

Seven placebo-controlled randomized trials involving 1421 patients were analyzed. Pairwise analysis showed that body weight increases were 4.6 kg (95% confidence interval [CI] 0.83–8.37 kg) for olanzapine, 3.82 kg (95% CI 0.73–6.91 kg) for espindolol (20 mg), 2.36 kg (95% CI 1.84–2.89 kg) for anamorelin (100 mg), and 1.31 kg (95% CI 0.42–2.19 kg) for anamorelin (50 mg). In terms of safety profiles, olanzapine demonstrated the lowest odds ratio when compared to placebo, at 0.26 (95% CI 0.07–0.94), followed by anamorelin (50 mg) at 0.86 (95% CI 0.30–2.48), and anamorelin (100 mg) at 0.89 (95% CI 0.42–1.88). However, network meta-analysis could not confirm the superiority of olanzapine over anamorelin in terms of efficacy and safety.

Conclusion

Both olanzapine and anamorelin are useful in improving body weight in patients with cancer cachexia. Personalization may be helpful for different patients.

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癌症恶病质药物治疗的有效性和安全性：系统综述和网络荟萃分析。

背景：癌症恶病质影响着一半以上的癌症患者，降低了他们的生存率。目前迫切需要基于证据的方法来优化治疗：方法：我们进行了一项系统综述和网络荟萃分析，以评估不同药物疗法治疗癌症恶病质的有效性和安全性。检索了 2000 年 1 月 1 日至 2024 年 3 月 20 日期间的三个数据库（PubMed、Cochrane Library 和 Web of Science）。采用随机效应模型，使用 R 软件中的 netmeta 软件包计算汇总效应：结果：分析了涉及 1421 名患者的七项安慰剂对照随机试验。配对分析显示，奥氮平的体重增加幅度为4.6千克（95%置信区间[CI] 0.83-8.37千克），埃辛洛尔（20毫克）的体重增加幅度为3.82千克（95%置信区间0.73-6.91千克），阿那莫瑞林（100毫克）的体重增加幅度为2.36千克（95%置信区间1.84-2.89千克），阿那莫瑞林（50毫克）的体重增加幅度为1.31千克（95%置信区间0.42-2.19千克）。在安全性方面，与安慰剂相比，奥氮平的几率最低，为 0.26（95% CI 0.07-0.94），其次是阿那莫瑞林（50 毫克），为 0.86（95% CI 0.30-2.48），阿那莫瑞林（100 毫克）为 0.89（95% CI 0.42-1.88）。然而，网络荟萃分析无法证实奥氮平在疗效和安全性方面优于阿那莫瑞林：结论：奥氮平和阿那莫林都有助于改善癌症恶病质患者的体重。个性化治疗可能对不同患者有所帮助。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.

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