Comparative Effectiveness of Taxane‐Containing Regimens for Treatment of HER2‐Negative Metastatic Breast Cancer: A Network Meta‐analysis

Dong, Lei; Zhu, Lina; Xie, Bin; Li, Ji‐bin; Ding, Tao; Yunfa, Jiang; Zhu, Zhongning

doi:10.1002/phar.2344

Cited by 4 publications

(4 citation statements)

References 39 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Paclitaxel/capecitabine/BEV was reported as the most effective combination in two meta-analyses of BEV in mBC. These analyses included 16 and 20 randomized controlled trials of BEV in different lines of treatment [ 21 , 22 ]. This is in contrast to our analysis, according to which there was no difference in efficacy between taxane monotherapy and taxane-based chemotherapy combinations.…”

Section: Discussionmentioning

confidence: 99%

Front-Line Bevacizumab plus Chemotherapy with or without Maintenance Therapy for Metastatic Breast Cancer: An Observational Study by the Hellenic Oncology Research Group

et al. 2022

View full text Add to dashboard Cite

Front-line bevacizumab (BEV) in combination with taxanes offers benefit in progression-free survival (PFS) in metastatic breast cancer (mBC). The medical records of mBC patients, treated with front-line BEV-based chemotherapy, were retrospectively reviewed in order to generate real life safety and efficacy data. Patients with human epidermal growth factor receptor 2 (HER2)-negative mBC treated with front-line BEV in combination with chemotherapy were eligible. Maintenance therapy with BEV and/or hormonal agents was at the physicians’ discretion. Among the 387 included patients, the most common adverse events were anemia (61.9%, mainly grade 1), grade 3/4 neutropenia (16.5%), grade 1/2 fatigue (22.3%), and grade 1/2 neuropathy (19.6%). Dose reductions were required in 164 cycles (7.1%) and toxicity led to treatment discontinuation in 21 patients (5.4%). The median PFS and the median overall survival (OS) were 13.3 (95% CI: 11.7–14.8) and 32.3 months (95% CI: 27.7–36.9), respectively. Maintenance therapy, with hormonal agents (ET) and/or BEV, was associated with longer OS versus no maintenance therapy (47.2 versus 23.6 months; p < 0.001) in patients with hormone receptor (HR)-positive disease and BEV maintenance offered longer OS versus no maintenance in patients with HR-negative disease (52.8 versus 23.3; p = 0.023). These real-life data show that front-line BEV-based chemotherapy in HER2-negative mBC patients is an effective treatment with an acceptable toxicity profile. The potential benefit of maintenance treatment, especially ET, is important and warrants further research.

show abstract

Section: Discussionmentioning

confidence: 99%

Front-Line Bevacizumab plus Chemotherapy with or without Maintenance Therapy for Metastatic Breast Cancer: An Observational Study by the Hellenic Oncology Research Group

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The analysis also found that paclitaxel-based combinations were more effective than paclitaxel alone for efficacy in ORR, which is similar to the case of capecitabine in our analysis. Further improvement in OS was associated with the taxane combination regimens – evidence which motivated us to embark on the current analysis [28].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Capecitabine Alone or in Combination in Advanced Metastatic Breast Cancer Patients Previously Treated with Anthracycline and Taxane: A Systematic Review and Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

Background: Capecitabine is frequently used alone or combined with other chemotherapy agents for the treatment of metastatic breast cancer in relapsed patients. Objective: The objective of this meta-analysis is to evaluate the effectiveness and safety of capecitabine monotherapy versus combination in the treatment of metastatic breast cancer patients pretreated with anthracycline and taxane. Methods: Eligible randomized controlled trials examining the efficacy and safety of capecitabine alone compared to capecitabine combination were systematically searched. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and grades 3–4 drug-related adverse events were the outcomes assessed. Results: A total of 6,714 patients of 9 trials were involved in the pooled analysis. Our findings demonstrated that capecitabine combination is significantly superior to capecitabine monotherapy in improving PFS (hazard ratio [HR] 1.32, 95% CI 1.13–1.54, p < 0.0001) and ORR (risk ratio [RR] 0.67, 95% CI 0.54–0.83, p < 0.001), but it was insignificant in OS (HR 1.09, 95% CI 0.98–1.22, p = 0.12). On the other hand, the incidence of non-hematological adverse events such as hand-foot syndrome and diarrhea was lower in capecitabine combination compared to capecitabine monotherapy. Conclusion: Capecitabine-based combination chemotherapy showed superiority over capecitabine monotherapy in terms of PFS and ORR, with no significant difference in OS. Non-hematological adverse effects such as hand-foot syndrome were fewer with a combination regimen. However, hematological adverse events were fewer with capecitabine monotherapy regimen.

show abstract

“…About 5-10% of breast cancer patients have metastatic disease, while 20-40% of early breast cancer patients eventually develop metastatic breast cancer [1]. Advanced tumors, especially HER2-negative metastatic breast cancer, are generally considered to be incurable despite the continuous development of therapeutic drugs [2][3][4]. Te prognosis of metastatic breast cancer is also relatively poor.…”

Section: Introductionmentioning

confidence: 99%

“…The median survival period of patients is only 2-3 years, and the 5-year survival rate is 23–26%. Therefore, metastatic breast cancer remains a major medical challenge [ 4 ]. For HER2-negative local recurrent or metastatic breast cancer, the first-line treatment options in Europe include single-agent chemotherapy and bevacizumab combined with chemotherapy drugs (paclitaxel or capecitabine).…”

Section: Introductionmentioning

confidence: 99%

Efficacy Evaluation of Bevacizumab Combined with Capecitabine in the Treatment of HER2-Negative Metastatic Breast Cancer: A Meta-Analysis

Chen

Xiang

2023

Journal of Oncology

View full text Add to dashboard Cite

Objective. This study aims to evaluate the efficacy of bevacizumab combined with capecitabine in treating HER2-negative metastatic breast cancer through meta-analysis. Methods. We searched literature from databases, including PubMed, Web of Science, Wiley Online Library, Ovid, CNKI, and Wanfang databases, for randomized controlled trials (RCTs) of bevacizumab combined with capecitabine (experimental group) and other treatments (control group) for HER2-negative metastatic breast cancer. Retrieved articles were published from the establishment of the database to August 9, 2022. The main outcome indicators were disease progression rate (RDP), disease progression-free survival (PFS), 1-year survival rate (OSR), the occurrence of serious adverse events (SAEs), and objective remission rate (ORR). The risk of bias was assessed according to the Cochrane systematic evaluation tool. Then, the meta-analysis was carried out using Stata16.0 software, and subgroup analysis was carried out based on various intervention methods in the control group. Results. 8 RCTs were finally included in this study, including 2470 patients with HER2-negative metastatic breast cancer. The results of meta-analysis showed that bevacizumab combined with capecitabine had no significant advantage over the control group in terms of RDP, but the results of subgroup analysis were consistent and significant (subgroup 1 (bevacizumab or chemotherapy): DR = −0.03, 95% CI (−0.14, 0.09), P = 0.01 ; subgroup 2 (bevacizumab plus paclitaxel therapy): DR = −0.03, 95% CI (−0.14, 0.09), P = 0.03 ). Furthermore, there was no statistical difference in terms of PFS of the experimental group (MD = 9.24, 95% CI (7.88, 32.67), P = 0.05 ). However, the subgroup analysis showed that the combination of bevacizumab and capecitabine demonstrated a more significant significance than bevacizumab or chemotherapy alone (subgroup 1: MD = 10.11, 95% CI (7.88, 12.34), P = 0.00 ). Compared with the control group, the experimental group had significant differences in OSR (DR = 0.07, 95% CI (−0.01, 0.15), P = 0.00 ) and ORR (DR = 0.07, 95% CI (−0.01, 0.15), P = 0.00 ). In terms of safety, the incidence of serious adverse events in the experimental group did not show a statistically significant difference (MD = 0.01, 95% CI (−0.21, 0.19), P = 0.82 ). When subgroup analyses were performed, the bevacizumab plus capecitabine regimen was associated with an increased incidence of serious adverse events compared with the drug alone (subgroup 1: MD = 0.02, 95% CI (−0.16, 0.20), P = 0.00 ) but a reduction in serious adverse events compared with the bevacizumab plus paclitaxel regimen (subgroup 2: DR = −0.01, 95% CI (−0.21, 0.19), P = 0.00 ). Conclusion. The combination therapy of bevacizumab and capecitabine can significantly improve the RDP and OSR of patients compared with the control group. The PFS and ORR of the experimental group are significantly higher than those of bevacizumab or chemotherapy alone. Still, no statistical difference was observed for these outcome indicators between two combined treatments of bevacizumab with capecitabine or paclitaxel. Although this combined treatment scheme may increase the incidence of serious adverse events compared with that of bevacizumab or chemotherapy alone, the incidence of adverse events was decreased compared with bevacizumab combined with paclitaxel. Therefore, the chemotherapy regimen for HER2-negative metastatic breast cancer in clinical practice can be selected according to the actual situation of the patients.

show abstract

Comparative Effectiveness of Taxane‐Containing Regimens for Treatment of HER2‐Negative Metastatic Breast Cancer: A Network Meta‐analysis

Cited by 4 publications

References 39 publications

Front-Line Bevacizumab plus Chemotherapy with or without Maintenance Therapy for Metastatic Breast Cancer: An Observational Study by the Hellenic Oncology Research Group

Front-Line Bevacizumab plus Chemotherapy with or without Maintenance Therapy for Metastatic Breast Cancer: An Observational Study by the Hellenic Oncology Research Group

Efficacy and Safety of Capecitabine Alone or in Combination in Advanced Metastatic Breast Cancer Patients Previously Treated with Anthracycline and Taxane: A Systematic Review and Meta-Analysis

Efficacy Evaluation of Bevacizumab Combined with Capecitabine in the Treatment of HER2-Negative Metastatic Breast Cancer: A Meta-Analysis

Contact Info

Product

Resources

About