The optimal choice of chemotherapy regimens for patients with relapsed platinum-resistant epithelial ovarian cancer/primary peritoneal/fallopian tube cancer — protocol for a systematic review and network meta-analysis

Abstract

Highlights

This protocol will provide the basic method to conduct the network meta-analysis of relapsed platinum-resistant epithelial ovarian cancer/primary peritoneal/fallopian tube cancer. And when the article finished, it will assess the efficacy and safety of different second line chemotherapy drugs including single and combined chemotherapy regiments and targeted therapy to provide more evidence to clinicians.

Abstract

Objectiv e: Debulking surgery (residual disease of less than 1 cm) followed by platinum-taxane chemotherapy is the current standard therapy for patients with epithelial ovarian cancer, primary peritoneal carcinoma and primary fallopian cancer. But the prognosis remains poor. Several chemotherapy regimens could be selected for patients with recrudescent cancer. However, the standard second chemotherapy regimen remains a subject of debate. The purpose of our study is to carry out a systematic review and network meta-analysis to compare the efficacy and safety of different regimens for recurrent platinum-resistant ovarian cancer based on existing randomized controlled trials (RCTs). Methods and analysis : Medline, EMBASE, Cochrane Library and Cochrane Library databases, Science Citation Index Expanded, Conference Proceedings Citation Index-Science and ClinicalTrials.gov will be systematically searched for eligible studies. Randomized controlled trials (RCT) on chemotherapy, immune therapy, biological therapy, targeted therapy for recurrent platinum-resistant ovarian cancer with multiple outcome measures will be included. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primary outcomes are overall survival and median survival time. The secondary outcomes include the safety and side effects of these regimens. Direct meta-analysis and network meta-analysis (NMA) will be conducted to compare different regimens. Conclusion : The results of this network meta-analysis will provide direct and indirect evidence of treatments for recurrent platinum-resistant ovarian cancer, and it may provide a ranking of the chemotherapy regimens for patients and gynecological oncologists to help them select the best option.

Translated abstract

目的 上皮性卵巢癌、原发性腹膜癌、输卵管癌预后较差,减瘤术联合紫杉醇加铂类化疗是目前的首选方案。由于其二线化疗方案的选择较多,目前并无标准首选方案, 本计划书将对应用网状meta分析对铂类耐药的卵巢癌二线化疗方案的优化选择进行先期计划。 方法 选取 Medline, EMBASE, Cochrane Library and Cochrane Library databases, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, ClinicalTrials.gov 数据库进行文献检索。纳入复发耐药型卵巢癌化疗,免疫治疗,生物治疗,靶向治疗的随机对照试验。应用 Cochrane Risk of Bias Tool 评估纳入的文献质量。主要观察指标为：中位生存期和整体生存率。次要观察指标为：有效性和安全性方面的评价。应用直接meta分析与间接meta分析（应用network meta-analysis (NMA) ）进行数据统计。 结论 应用network meta分析,对复发性铂类耐药的随机对照试验提供的数据进行直接和间接比较,将可能对试验涉及的多种治疗方案的效果和安全性进行优化排序,为临床医师在实际工作中提供建议。