DOI: 10.1002/cncr.22809. Gemcitabine‐based combinations for inoperable pancreatic cancer: Have we made real progress?

Gemcitabine‐based combinations for inoperable pancreatic cancer: Have we made real progress?

10.1002/cncr.22809

Crossref journal-article

Wiley

Cancer (311)

Abstract

AbstractBACKGROUND.Several attempts have been made at improving the efficacy of gemcitabine in advanced pancreatic cancer by combining it with other chemotherapeutic or molecularly targeted agents. However, randomized trials have produced conflicting results.METHODS.All prospective, randomized, phase 3 trials that compared single‐agent gemcitabine with gemcitabine‐based combinations were considered eligible for the current analysis. A literature‐based meta‐analysis was performed, event‐based relative risk ratios with 95% confidence intervals were derived through both a fixed‐effect model approach and a random‐effect model approach, and overall survival (OS) was explored as the primary endpoint. To estimate the magnitude of the eventual benefit, absolute differences and the number of patients needed to treat (NNT) for 1 patient to benefit were calculated. A sensitivity analysis for OS was performed according to the type of agent used in combination with gemcitabine.RESULTS.Twenty trials that involved 6296 patients were identified. No significant differences in the primary endpoint were observed in the overall population or in the sensitivity analysis. Conversely, a significant advantage was evident with regard to both progression‐free survival (PFS) and the overall response rate (ORR) in the overall population, with an absolute benefit of 2.6% (NTT = 39 patients) and 3.0% (NNT = 33 patients). Platinum combinations led to the greatest absolute benefits for PFS and ORR compared with single‐agent gemcitabine (10% and 6.5%, respectively), but this did not result in an OS benefit. Improvement in PFS, but not in the ORR, was correlated with an improvement in OS.CONCLUSIONS.Single‐agent gemcitabine remains the standard of care for patients with advanced pancreatic cancer. However, platinum/gemcitabine combinations appeared to improve PFS and the ORR and, thus, may be considered in selected patients. Cancer 2007. © 2007 American Cancer Society.

Bibliography

Bria, E., Milella, M., Gelibter, A., Cuppone, F., Pino, M. S., Ruggeri, E. M., Carlini, P., NisticÃ², C., Terzoli, E., Cognetti, F., & Giannarelli, D. (2007). Gemcitabineâbased combinations for inoperable pancreatic cancer: Have we made real progress? Cancer, 110(3), 525â533. Portico.

Authors 11

Emilio Bria (first)
Michele Milella (additional)
Alain Gelibter (additional)
Federica Cuppone (additional)
Maria Simona Pino (additional)
Enzo Maria Ruggeri (additional)
Paolo Carlini (additional)
Cecilia Nisticò (additional)
Edmondo Terzoli (additional)
Francesco Cognetti (additional)
Diana Giannarelli (additional)

References 38 Referenced 72

10.3322/canjclin.56.2.106
10.1200/JCO.1997.15.6.2403
10.1200/JCO.2005.06.023
10.1016/S1359-6349(05)82014-2
10.1200/JCO.2004.10.112
10.1200/JCO.2003.02.098
10.1038/sj.bjc.6600446
10.1200/JCO.2001.19.15.3447
{'issue': '1', 'key': 'e_1_2_6_10_2', 'first-page': '16S', 'article-title': 'G17DT+gemcitabine [Gem] versus placebo+Gem in untreated subjects with locally advanced, recurrent, or metastatic adenocarcinoma of the pancreas: results of a randomized, double‐blind, multinational, multicenter study', 'volume': '23', 'author': 'Shapiro J', 'year': '2005', 'journal-title': 'J Clin Oncol.'} / J Clin Oncol. / G17DT+gemcitabine [Gem] versus placebo+Gem in untreated subjects with locally advanced, recurrent, or metastatic adenocarcinoma of the pancreas: results of a randomized, double‐blind, multinational, multicenter study by Shapiro J (2005)
10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6
10.1634/theoncologist.7-3-181
10.1002/cncr.21886
{'key': 'e_1_2_6_14_2', 'volume-title': 'Survival Analysis: A Practical Approach', 'author': 'Parmar MKB', 'year': '1995'} / Survival Analysis: A Practical Approach by Parmar MKB (1995)
10.1136/bmj.317.7168.1309
10.1002/cncr.10323
10.1200/JCO.2005.05.1490
10.1016/S1470-2045(05)70175-3
{'key': 'e_1_2_6_19_2', 'first-page': '14S', 'article-title': 'A prospective randomized trial of gemcitabine alone or gemcitabine + cisplatin in the treatment of metastatic pancreatic cancer', 'volume': '22', 'author': 'Li CP', 'year': '2004', 'journal-title': 'J Clin Oncol.'} / J Clin Oncol. / A prospective randomized trial of gemcitabine alone or gemcitabine + cisplatin in the treatment of metastatic pancreatic cancer by Li CP (2004)
{'key': 'e_1_2_6_20_2', 'first-page': '21', 'article-title': 'Gemcitabine (G) or gemcitabine plus cisplatin (GC) as first‐line treatment in Chinese patients (pts) with locally advanced (LAPC) and metastatic pancreatic cancer (MPC): a multicenter, randomized, study', 'author': 'Wang XY', 'year': '2002', 'journal-title': 'Proc Am Soc Clin Oncol.'} / Proc Am Soc Clin Oncol. / Gemcitabine (G) or gemcitabine plus cisplatin (GC) as first‐line treatment in Chinese patients (pts) with locally advanced (LAPC) and metastatic pancreatic cancer (MPC): a multicenter, randomized, study by Wang XY (2002)
10.1200/JCO.2002.11.149
{'key': 'e_1_2_6_22_2', 'first-page': '310s', 'article-title': 'Gemcitabine (G) plus Capecitabine (C) versus G alone in locally advanced or metastatic pancreatic cancer. A randomized phase III study of the Swiss Group for Clinical Cancer Research (SAKK) and the Central European Cooperative OncologyGroup (CECOG)', 'volume': '23', 'author': 'Hermann R', 'year': '2005', 'journal-title': 'Proc Am Soc Clin Oncol.'} / Proc Am Soc Clin Oncol. / Gemcitabine (G) plus Capecitabine (C) versus G alone in locally advanced or metastatic pancreatic cancer. A randomized phase III study of the Swiss Group for Clinical Cancer Research (SAKK) and the Central European Cooperative OncologyGroup (CECOG) by Hermann R (2005)
10.1200/jco.2004.22.90140.4131 / J Clin Oncol. / Randomized controlled trial of gemcitabine in combination with UFT versus gemcitabine alone in patients with advanced pancreatic cancer by Ohkawa S (2004)
{'issue': '16', 'key': 'e_1_2_6_24_2', 'first-page': '1092', 'article-title': 'A randomised, prospective, multicenter, phase III trial of gemcitabine, 5‐fluorouracil (5‐FU), folinic acid vs gemcitabine alone in patients with advanced pancreatic cancer', 'volume': '23', 'author': 'Riess H', 'year': '2005', 'journal-title': 'J Clin Oncol.'} / J Clin Oncol. / A randomised, prospective, multicenter, phase III trial of gemcitabine, 5‐fluorouracil (5‐FU), folinic acid vs gemcitabine alone in patients with advanced pancreatic cancer by Riess H (2005)
10.1093/annonc/mdi309
10.1038/sj.bjc.6603301
10.1200/JCO.2006.07.0201
10.1200/JCO.2004.12.082
10.1200/JCO.2006.07.9525
10.1002/14651858.CD002093.pub2
{'issue': '9', 'key': 'e_1_2_6_31_2', 'first-page': 'ix308', 'article-title': 'Meta‐analysis of randomized trials: evaluation of benefit from combination chemotherapy applied in advanced pancreatic cancer', 'volume': '17', 'author': 'Heinemann V', 'year': '2006', 'journal-title': 'Ann Oncol.'} / Ann Oncol. / Meta‐analysis of randomized trials: evaluation of benefit from combination chemotherapy applied in advanced pancreatic cancer by Heinemann V (2006)
10.1093/jnci/djk022
10.3748/wjg.v12.i43.6973
10.1200/jco.2006.24.18_suppl.4126 / J Clin Oncol. / Current status of targeted agents in advanced pancreatic cancer (APC): a pooled analysis of 2,361 patients (pts) enrolled in six phase III trials by Bria E (2006)
10.1634/theoncologist.10-8-565
10.1038/sj.bjc.6602687
10.1002/cncr.21286
10.1200/JCO.2005.03.8315
{'key': 'e_1_2_6_39_2', 'first-page': '180S', 'article-title': 'Phase III trial of gemcitabine (30‐minute infusion) versus gemcitabine (fixed‐dose‐rate infusion [FDR]) versus gemcitabine + oxaliplatin (GEMOX) in patients with advanced pancreatic cancer (E6201)', 'volume': '24', 'author': 'Poplin E', 'year': '2006', 'journal-title': 'Proc Am Soc Clin Oncol.'} / Proc Am Soc Clin Oncol. / Phase III trial of gemcitabine (30‐minute infusion) versus gemcitabine (fixed‐dose‐rate infusion [FDR]) versus gemcitabine + oxaliplatin (GEMOX) in patients with advanced pancreatic cancer (E6201) by Poplin E (2006)

Dates

Type	When
Created	18 years, 2 months ago (June 18, 2007, 11:50 a.m.)
Deposited	1 year, 9 months ago (Nov. 20, 2023, 3:05 p.m.)
Indexed	5 months, 1 week ago (March 22, 2025, 5:03 a.m.)
Issued	18 years, 2 months ago (June 18, 2007)
Published	18 years, 2 months ago (June 18, 2007)
Published Online	18 years, 2 months ago (June 18, 2007)
Published Print	18 years ago (Aug. 1, 2007)

Funders 0

None

BibTeX

@article{Bria_2007, title={Gemcitabine‐based combinations for inoperable pancreatic cancer: Have we made real progress?: A meta‐analysis of 20 phase 3 trials}, volume={110}, ISSN={1097-0142}, url={http://dx.doi.org/10.1002/cncr.22809}, DOI={10.1002/cncr.22809}, number={3}, journal={Cancer}, publisher={Wiley}, author={Bria, Emilio and Milella, Michele and Gelibter, Alain and Cuppone, Federica and Pino, Maria Simona and Ruggeri, Enzo Maria and Carlini, Paolo and Nisticò, Cecilia and Terzoli, Edmondo and Cognetti, Francesco and Giannarelli, Diana}, year={2007}, month=jun, pages={525–533} }

JSON

{
  "indexed": {
    "date-parts": [
      [
        2025,
        3,
        22
      ]
    ],
    "date-time": "2025-03-22T09:03:19Z",
    "timestamp": 1742634199038
  },
  "reference-count": 38,
  "publisher": "Wiley",
  "issue": "3",
  "license": [
    {
      "start": {
        "date-parts": [
          [
            2007,
            6,
            18
          ]
        ],
        "date-time": "2007-06-18T00:00:00Z",
        "timestamp": 1182124800000
      },
      "content-version": "vor",
      "delay-in-days": 0,
      "URL": "http://onlinelibrary.wiley.com/termsAndConditions#vor"
    }
  ],
  "content-domain": {
    "domain": [],
    "crossmark-restriction": false
  },
  "published-print": {
    "date-parts": [
      [
        2007,
        8
      ]
    ]
  },
  "abstract": "<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND.</jats:title><jats:p>Several attempts have been made at improving the efficacy of gemcitabine in advanced pancreatic cancer by combining it with other chemotherapeutic or molecularly targeted agents. However, randomized trials have produced conflicting results.</jats:p></jats:sec><jats:sec><jats:title>METHODS.</jats:title><jats:p>All prospective, randomized, phase 3 trials that compared single\u2010agent gemcitabine with gemcitabine\u2010based combinations were considered eligible for the current analysis. A literature\u2010based meta\u2010analysis was performed, event\u2010based relative risk ratios with 95% confidence intervals were derived through both a fixed\u2010effect model approach and a random\u2010effect model approach, and overall survival (OS) was explored as the primary endpoint. To estimate the magnitude of the eventual benefit, absolute differences and the number of patients needed to treat (NNT) for 1 patient to benefit were calculated. A sensitivity analysis for OS was performed according to the type of agent used in combination with gemcitabine.</jats:p></jats:sec><jats:sec><jats:title>RESULTS.</jats:title><jats:p>Twenty trials that involved 6296 patients were identified. No significant differences in the primary endpoint were observed in the overall population or in the sensitivity analysis. Conversely, a significant advantage was evident with regard to both progression\u2010free survival (PFS) and the overall response rate (ORR) in the overall population, with an absolute benefit of 2.6% (NTT = 39 patients) and 3.0% (NNT = 33 patients). Platinum combinations led to the greatest absolute benefits for PFS and ORR compared with single\u2010agent gemcitabine (10% and 6.5%, respectively), but this did not result in an OS benefit. Improvement in PFS, but not in the ORR, was correlated with an improvement in OS.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS.</jats:title><jats:p>Single\u2010agent gemcitabine remains the standard of care for patients with advanced pancreatic cancer. However, platinum/gemcitabine combinations appeared to improve PFS and the ORR and, thus, may be considered in selected patients. Cancer 2007. \u00a9 2007 American Cancer Society.</jats:p></jats:sec>",
  "DOI": "10.1002/cncr.22809",
  "type": "journal-article",
  "created": {
    "date-parts": [
      [
        2007,
        6,
        18
      ]
    ],
    "date-time": "2007-06-18T15:50:41Z",
    "timestamp": 1182181841000
  },
  "page": "525-533",
  "source": "Crossref",
  "is-referenced-by-count": 72,
  "title": "Gemcitabine\u2010based combinations for inoperable pancreatic cancer: Have we made real progress?",
  "prefix": "10.1002",
  "volume": "110",
  "author": [
    {
      "given": "Emilio",
      "family": "Bria",
      "sequence": "first",
      "affiliation": []
    },
    {
      "given": "Michele",
      "family": "Milella",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Alain",
      "family": "Gelibter",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Federica",
      "family": "Cuppone",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Maria Simona",
      "family": "Pino",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Enzo Maria",
      "family": "Ruggeri",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Paolo",
      "family": "Carlini",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Cecilia",
      "family": "Nistic\u00f2",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Edmondo",
      "family": "Terzoli",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Francesco",
      "family": "Cognetti",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "Diana",
      "family": "Giannarelli",
      "sequence": "additional",
      "affiliation": []
    }
  ],
  "member": "311",
  "published-online": {
    "date-parts": [
      [
        2007,
        6,
        18
      ]
    ]
  },
  "reference": [
    {
      "key": "e_1_2_6_2_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.3322/canjclin.56.2.106"
    },
    {
      "key": "e_1_2_6_3_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.1997.15.6.2403"
    },
    {
      "key": "e_1_2_6_4_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2005.06.023"
    },
    {
      "key": "e_1_2_6_5_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1016/S1359-6349(05)82014-2"
    },
    {
      "key": "e_1_2_6_6_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2004.10.112"
    },
    {
      "key": "e_1_2_6_7_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2003.02.098"
    },
    {
      "key": "e_1_2_6_8_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1038/sj.bjc.6600446"
    },
    {
      "key": "e_1_2_6_9_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2001.19.15.3447"
    },
    {
      "issue": "1",
      "key": "e_1_2_6_10_2",
      "first-page": "16S",
      "article-title": "G17DT+gemcitabine [Gem] versus placebo+Gem in untreated subjects with locally advanced, recurrent, or metastatic adenocarcinoma of the pancreas: results of a randomized, double\u2010blind, multinational, multicenter study",
      "volume": "23",
      "author": "Shapiro J",
      "year": "2005",
      "journal-title": "J Clin Oncol."
    },
    {
      "key": "e_1_2_6_11_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6"
    },
    {
      "key": "e_1_2_6_12_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1634/theoncologist.7-3-181"
    },
    {
      "key": "e_1_2_6_13_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1002/cncr.21886"
    },
    {
      "key": "e_1_2_6_14_2",
      "volume-title": "Survival Analysis: A Practical Approach",
      "author": "Parmar MKB",
      "year": "1995"
    },
    {
      "key": "e_1_2_6_15_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1136/bmj.317.7168.1309"
    },
    {
      "key": "e_1_2_6_16_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1002/cncr.10323"
    },
    {
      "key": "e_1_2_6_17_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2005.05.1490"
    },
    {
      "key": "e_1_2_6_18_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1016/S1470-2045(05)70175-3"
    },
    {
      "key": "e_1_2_6_19_2",
      "first-page": "14S",
      "article-title": "A prospective randomized trial of gemcitabine alone or gemcitabine + cisplatin in the treatment of metastatic pancreatic cancer",
      "volume": "22",
      "author": "Li CP",
      "year": "2004",
      "journal-title": "J Clin Oncol."
    },
    {
      "key": "e_1_2_6_20_2",
      "first-page": "21",
      "article-title": "Gemcitabine (G) or gemcitabine plus cisplatin (GC) as first\u2010line treatment in Chinese patients (pts) with locally advanced (LAPC) and metastatic pancreatic cancer (MPC): a multicenter, randomized, study",
      "author": "Wang XY",
      "year": "2002",
      "journal-title": "Proc Am Soc Clin Oncol."
    },
    {
      "key": "e_1_2_6_21_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2002.11.149"
    },
    {
      "key": "e_1_2_6_22_2",
      "first-page": "310s",
      "article-title": "Gemcitabine (G) plus Capecitabine (C) versus G alone in locally advanced or metastatic pancreatic cancer. A randomized phase III study of the Swiss Group for Clinical Cancer Research (SAKK) and the Central European Cooperative OncologyGroup (CECOG)",
      "volume": "23",
      "author": "Hermann R",
      "year": "2005",
      "journal-title": "Proc Am Soc Clin Oncol."
    },
    {
      "key": "e_1_2_6_23_2",
      "doi-asserted-by": "crossref",
      "first-page": "14S",
      "DOI": "10.1200/jco.2004.22.90140.4131",
      "article-title": "Randomized controlled trial of gemcitabine in combination with UFT versus gemcitabine alone in patients with advanced pancreatic cancer",
      "volume": "22",
      "author": "Ohkawa S",
      "year": "2004",
      "journal-title": "J Clin Oncol."
    },
    {
      "issue": "16",
      "key": "e_1_2_6_24_2",
      "first-page": "1092",
      "article-title": "A randomised, prospective, multicenter, phase III trial of gemcitabine, 5\u2010fluorouracil (5\u2010FU), folinic acid vs gemcitabine alone in patients with advanced pancreatic cancer",
      "volume": "23",
      "author": "Riess H",
      "year": "2005",
      "journal-title": "J Clin Oncol."
    },
    {
      "key": "e_1_2_6_25_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1093/annonc/mdi309"
    },
    {
      "key": "e_1_2_6_26_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1038/sj.bjc.6603301"
    },
    {
      "key": "e_1_2_6_27_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2006.07.0201"
    },
    {
      "key": "e_1_2_6_28_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2004.12.082"
    },
    {
      "key": "e_1_2_6_29_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2006.07.9525"
    },
    {
      "key": "e_1_2_6_30_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1002/14651858.CD002093.pub2"
    },
    {
      "issue": "9",
      "key": "e_1_2_6_31_2",
      "first-page": "ix308",
      "article-title": "Meta\u2010analysis of randomized trials: evaluation of benefit from combination chemotherapy applied in advanced pancreatic cancer",
      "volume": "17",
      "author": "Heinemann V",
      "year": "2006",
      "journal-title": "Ann Oncol."
    },
    {
      "key": "e_1_2_6_32_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1093/jnci/djk022"
    },
    {
      "key": "e_1_2_6_33_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.3748/wjg.v12.i43.6973"
    },
    {
      "key": "e_1_2_6_34_2",
      "doi-asserted-by": "crossref",
      "first-page": "18S",
      "DOI": "10.1200/jco.2006.24.18_suppl.4126",
      "article-title": "Current status of targeted agents in advanced pancreatic cancer (APC): a pooled analysis of 2,361 patients (pts) enrolled in six phase III trials",
      "volume": "24",
      "author": "Bria E",
      "year": "2006",
      "journal-title": "J Clin Oncol."
    },
    {
      "key": "e_1_2_6_35_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1634/theoncologist.10-8-565"
    },
    {
      "key": "e_1_2_6_36_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1038/sj.bjc.6602687"
    },
    {
      "key": "e_1_2_6_37_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1002/cncr.21286"
    },
    {
      "key": "e_1_2_6_38_2",
      "doi-asserted-by": "publisher",
      "DOI": "10.1200/JCO.2005.03.8315"
    },
    {
      "key": "e_1_2_6_39_2",
      "first-page": "180S",
      "article-title": "Phase III trial of gemcitabine (30\u2010minute infusion) versus gemcitabine (fixed\u2010dose\u2010rate infusion [FDR]) versus gemcitabine + oxaliplatin (GEMOX) in patients with advanced pancreatic cancer (E6201)",
      "volume": "24",
      "author": "Poplin E",
      "year": "2006",
      "journal-title": "Proc Am Soc Clin Oncol."
    }
  ],
  "container-title": "Cancer",
  "original-title": [],
  "language": "en",
  "link": [
    {
      "URL": "https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fcncr.22809",
      "content-type": "unspecified",
      "content-version": "vor",
      "intended-application": "text-mining"
    },
    {
      "URL": "https://onlinelibrary.wiley.com/doi/full/10.1002/cncr.22809",
      "content-type": "unspecified",
      "content-version": "vor",
      "intended-application": "similarity-checking"
    }
  ],
  "deposited": {
    "date-parts": [
      [
        2023,
        11,
        20
      ]
    ],
    "date-time": "2023-11-20T20:05:12Z",
    "timestamp": 1700510712000
  },
  "score": 1,
  "resource": {
    "primary": {
      "URL": "https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.22809"
    }
  },
  "subtitle": [
    "A meta\u2010analysis of 20 phase 3 trials"
  ],
  "short-title": [],
  "issued": {
    "date-parts": [
      [
        2007,
        6,
        18
      ]
    ]
  },
  "references-count": 38,
  "journal-issue": {
    "issue": "3",
    "published-print": {
      "date-parts": [
        [
          2007,
          8
        ]
      ]
    }
  },
  "alternative-id": [
    "10.1002/cncr.22809"
  ],
  "URL": "http://dx.doi.org/10.1002/cncr.22809",
  "relation": {},
  "ISSN": [
    "0008-543X",
    "1097-0142"
  ],
  "subject": [],
  "container-title-short": "Cancer",
  "published": {
    "date-parts": [
      [
        2007,
        6,
        18
      ]
    ]
  }
}