Addition of drug/s to a chemotherapy regimen for XXXX .

@entity1 @entity1665 @entity137 @entity390 @entity0 @entity5 @entity391 @entity1210
BACKGROUND: The addition of a chemotherapy drug or drugs to an established regimen is one method used to increase the dose and intensity of treatment for @entity0 . OBJECTIVES: To assess the effects of adding one or more chemotherapy drugs to an established regimen in @entity1 with @entity0 . SEARCH STRATEGY: We searched the Cochrane @entity0 Group's Specialised Register (to August 2009) using the codes for "advanced @entity0 " and "chemotherapy". This review is an update of the original Cochrane Review (Issue 3, 2006). SELECTION CRITERIA: Randomised trials with a first line regimen of at least two chemotherapy drugs compared to the same regimen plus the addition of one or more chemotherapy drugs in @entity1 with @entity0 . DATA COLLECTION AND ANALYSIS: Two authors extracted data independently from published trials. We derived hazard ratios (HR) from time-to-event outcomes where possible, and used a fixed-effect model for meta-analysis. We analysed response rates as dichotomous variables and extracted @entity137 data where available. MAIN RESULTS: We identified 17 trials reporting on 22 treatment comparisons (2674 @entity1 randomised). Fifteen trials (20 treatment comparisons) reported results for @entity5 response and 11 trials (14 treatment comparisons) published time-to-event data for overall survival. There were 1532 deaths in 2116 @entity1 randomised to trials of the addition of a drug to the regimen and control (the regimen alone). There was no detectable difference in overall survival between these @entity1 , with an overall HR of 0.96 (95% confidence interval (CI) 0.87 to 1.07, P = 0.47) and no significant heterogeneity. We found no difference in time to progression between these regimens, with an overall HR of 0.93 (95% CI 0.81 to 1.07, P = 0.31) and no significant heterogeneity. Addition of a drug to the regimen was favourably associated with @entity5 response rates (odds ratio 1.21, 95% CI 1.01 to 1.44, P = 0.04) although we observed significant heterogeneity for this outcome across the trials. Where measured, acute @entity137 such as @entity1665 , @entity390 and @entity391 and @entity1210 were more common with the addition of a drug. AUTHORS' CONCLUSIONS: The addition of one or more drugs to the regimen shows a statistically significant advantage for @entity5 response in @entity1 with @entity0 but the results suggest no difference in survival time or time to progression. The positive effect on @entity5 response was also associated with increased @entity137 .
