Table 3 AMSTAR2 and GRADE classification of the evidence
From: Chemotherapy and targeted therapy for advanced biliary tract cancers: an umbrella review
First author, Year | Type of Chemotherapy | Clinical Outcome | MA metric | AMSTAR2 | GRADE |
|---|---|---|---|---|---|
ALESSANDRO RIZZO,2020 [22] | G-based + anti-EGFR vs. G-based | OS | HR | Critically low | Low |
PFS | HR | Critically low | Low | ||
ORR | RR | Critically low | Very Low | ||
Toxicities–Neutropenia | RR | Critically low | Low | ||
Toxicities–Thrombocytopenia | RR | Critically low | Very Low | ||
Toxicities–Skin rash | RR | Critically low | Moderate | ||
Toxicities–Diarrhea | RR | Critically low | Very Low | ||
Toxicities–Fatigue | RR | Critically low | Very Low | ||
Lawrence Chen,2016 [16] | GP vs. G | Duration of OS | MD | Critically low | Low |
OS | HR | Critically low | Low | ||
Duration of PFS | MD | Critically low | Low | ||
PFS | HR | Critically low | Low | ||
ORR | OR | Critically low | Low | ||
GP + anti-EGFR vs. GP | Duration of OS | MD | Critically low | Low | |
OS | HR | Critically low | Low | ||
Duration of PFS | MD | Critically low | Low | ||
PFS | HR | Critically low | Low | ||
ORR | OR | Critically low | Low | ||
Ting Zheng,2020 [19] | GP vs. FP | ORR | RR | Critically low | Very Low |
DCR | RR | Critically low | Very Low | ||
PFS/TTP | HR | Critically low | Low | ||
OS | HR | Critically low | Low | ||
Toxicities–Neutropenia | NA | Critically low | Very Low | ||
Toxicities–Anemia | NA | Critically low | Very Low | ||
Toxicities–Trombocytopenia | NA | Critically low | Very Low | ||
Toxicities–Nausea/Vomiting | NA | Critically low | Very Low | ||
Toxicities–Anorexia | NA | Critically low | Very Low | ||
Toxicities–Nephropathy | NA | Critically low | Very Low | ||
Toxicities–Neuropathy | NA | Critically low | Very Low | ||
Xin ZHUANG,2017 [21] | G-based + anti-EGFR vs. G-based | Toxicities–Neutropenia | OR | Low | Very Low |
Toxicities–Thrombocytopenia | OR | Low | Very Low | ||
Toxicities–Anemia | OR | Low | Very Low | ||
Toxicities–Peripheral neuropathy | OR | Low | Very Low | ||
Toxicities–Increased AST/ALT | OR | Low | Very Low | ||
Heng Liu,2014 [18] | G-based vs. non-G-based | DRR | OR | Low | Low |
DCR | OR | Low | Very Low | ||
PFS | OR | Low | Low | ||
OS | OR | Low | Low | ||
Toxicities–Leukopenia | OR | Low | Moderate | ||
Toxicities–Anemia | OR | Low | High | ||
Toxicities–Neutropenia | OR | Low | Very Low | ||
Toxicities–Thrombocytopenia | OR | Low | Very Low | ||
Toxicities– Increased ALT level | OR | Low | Very Low | ||
G-based vs. G | Toxicities–Leukopenia | OR | Low | Low | |
Toxicities–Anemia | OR | Low | Very Low | ||
Toxicities–Neutropenia | OR | Low | Low | ||
Toxicities–Thrombocytopenia | OR | Low | Very Low | ||
Toxicities– Increased ALT level | OR | Low | Very Low | ||
Sheng Zhao,2016 [17] | G-based + anti-VEGFR/EGFR vs. G-based | Toxicities– Nausea | RR | Critically low | Very Low |
Toxicities– Vomiting | RR | Critically low | Very Low | ||
Toxicities– Diarrhea | RR | Critically low | Moderate | ||
Alessandro Rizzo,2022 [26] | Fluoropyrimidine-based doublet CHT vs. ASC or 5-FU/LV | OS | HR | Critically low | Low |
DCR | OR | Critically low | Moderate | ||
ORR | OR | Critically low | Moderate | ||
Wen-Jie Ma,2020 [27] | Fluoropyrimidine-based vs. Observation | OS | HR | Critically low | Moderate |
G-based vs. Observation | OS | HR | Critically low | Moderate | |
Julien Edeline,2022 [28] | G-based vs. Observation | RFS-All Patients | HR | Critically low | Low |
RFS-R1 resection Patients | HR | Critically low | Low | ||
RFS-N + tumor Patients | HR | Critically low | Low | ||
OS-All Patients | HR | Critically low | Low | ||
OS-R1 resection Patients | HR | Critically low | Low | ||
OS-N + tumor Patients | HR | Critically low | Low | ||
Abdel-Rahman O,2018 [29] | G + S-1 vs. S-1 | All-cause mortality at 1 year | RR | High | Very Low |
ORR(S-1 vs.G + S-1) | RR | High | Moderate | ||
Toxicities–Grade 1—4 Anaemia | RR | High | Very Low | ||
Toxicities–Grade 1—4 Thrombocytopenia | RR | High | Moderate | ||
Toxicities–Grade 1—4 Neutropenia | RR | High | Moderate | ||
Toxicities–Febrile Neutropenia | RR | High | Very Low | ||
Yan Li,2019 [30] | FOLFOX-4 vs. Observation | OS | HR | Critically low | — |
XP vs. GP | OS | HR | Critically low | — | |
G + S-1 vs. GC | OS | HR | Critically low | — | |
Jie Ying,2019 [31] | G-based CHT vs. single CHT(mainly FU alone) | DCR | RR | Critically low | — |
Fluoropyrimidine-based CHT vs. single TAs | DCR | RR | Critically low | — | |
Taxanes-based CHT vs. single CHT(mainly FU alone) | DCR | RR | Critically low | — | |
Fluoropyrimidine-based CHT vs. single CHT(mainly FU alone) | 1-year OS | RR | Critically low | — | |
Wei Zheng,2019 [32] | G + S-1 vs. G | ORR | OR | Critically low | — |
OS | HR | Critically low | — | ||
G + S-1 vs. 5-FU | ORR | OR | Critically low | — | |
OS | HR | Critically low | — | ||
CapC vs.5-FU | ORR | OR | Critically low | — | |
GEMOX vs. 5-FU | OS | HR | Critically low | — | |
FP vs. 5-FU | OS | HR | Critically low | — | |
Yanfeng Jiang,2021 [33] | Observation vs. Folfox-4 | PFS | HR | Critically low | — |
Observation vs. C-GEMOX | PFS | HR | Critically low | — | |
Observation vs. GEMOX + erlotinib | PFS | HR | Critically low | — | |
GP + cediranib vs. 5-FU | ORR (5-FU vs.GP + cediranib) | OR | Critically low | — | |
Toxicities–Neutropenia | OR | Critically low | — | ||
GP vs. 5-FU | Toxicities–Neutropenia | OR | Critically low | — | |
G + S-1 vs. 5-FU | Toxicities–Neutropenia | OR | Critically low | — | |
C-GEMOX vs. 5-FU | Toxicities–Neutropenia | OR | Critically low | — | |
RAM + GP vs. 5-FU | Toxicities–Neutropenia | OR | Critically low | — | |
MER + GP vs. 5-FU | Toxicities–Neutropenia | OR | Critically low | — | |
XELOX vs. G + XELOX | Toxicities–Vomiting | OR | Critically low | — | |
XELOX vs. GEMOX + erlotinib | Toxicities– Diarrhea | OR | Critically low | — |