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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 460 - 483 (24page)
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We aimed to explore what kind of endocrine treatments are optimal for hormone receptor-positive and human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer in some specific clinical situations. We searched randomized controlled trials in Embase, Medline, the Cochrane library, and PubMed from inception to April 1, 2020 and performed a network meta-analysis based on a Bayesian fixed-effects model. Progression-free survival (PFS) with hazard ratios and corresponding 95% confidence interval was defined as the primary endpoint, while overall survival (OS), objective response rate (ORR), clinical benefit rate and serious adverse events were used as secondary endpoints. A total of 35 studies involving 12,285 patients and 24 treatment options were included. In general, most co-treatment options prolonged PFS compared to single-agent therapy, of which aromatase inhibitor (AI) plus everolimus and fulvestrant plus palbociclib were probably the most effective agents, and the latter had the best safety record. However, despite the superior efficacy of fulvestrant plus capecitabine for PFS and OS, palpable toxic effects have been demonstrated for this treatment, so its application must be scrupulously considered. The results of subgroup analysis indicated that fulvestrant combined with palbociclib improved prognosis for phosphatidylinositol 3-kinase (PI3K)-mutated patients, PI3K-unmutated patients, patients with endocrine therapy resistance, and visceral metastatic patients, while no obvious improvement was detected in OS. Moreover, the efficacy of fulvestrant plus cyclin-dependent kinase 4/6 (CDK4/6) inhibitors was slightly better than that of AI plus CDK4/6 inhibitors, while AI plus everolimus was more efficacious than fulvestrant combined with everolimus in terms of PFS, OS, and ORR. In conclusion, our results provide moderate evidence that fulvestrant plus palbociclib and AI plus everolimus were the most effective treatments, while the efficacy and safety of fulvestrant plus palbociclib was obviously superior in some specific clinical situations.
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참고문헌 (65)
참고문헌 신청
Lindström LS / 2012 / Clinically used breast cancer markers such as estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 are unstable throughout tumor progression / J Clin Oncol 30:2601~2608
Francis PA / 2018 / Tailoring adjuvant endocrine therapy for premenopausal breast cancer / N Engl J Med 379:122~137
Milani A / 2014 / Overcoming endocrine resistance in metastatic breast cancer : current evidence and future directions / World J Clin Oncol 5:990~1001
Hanker AB / 2020 / Overcoming endocrine resistance in breast cancer / Cancer Cell 37:496~513
Sharifi MN / 2020 / Therapy after cyclin-dependent kinase inhibition in metastatic hormone receptor-positive breast cancer : resistance mechanisms and novel treatment strategies / Cancer 126:3400~3416
Francis PA / 2018 / Tailoring adjuvant endocrine therapy for premenopausal breast cancer / N Engl J Med 379:122~137
Milani A / 2014 / Overcoming endocrine resistance in metastatic breast cancer : current evidence and future directions / World J Clin Oncol 5:990~1001
Hanker AB / 2020 / Overcoming endocrine resistance in breast cancer / Cancer Cell 37:496~513
Sharifi MN / 2020 / Therapy after cyclin-dependent kinase inhibition in metastatic hormone receptor-positive breast cancer : resistance mechanisms and novel treatment strategies / Cancer 126:3400~3416
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