Efficacy and safety of first-line treatment for metastatic triple-negative breast cancer:A network meta-analysis  

作　　者：Mingqiang Shi Zhoujuan Li Guoshuang Shen Tianzhuo Wang Jinming Li Miaozhou Wang Zhen Liu Fuxing Zhao Dengfeng Ren Jiuda Zhao 

机构地区：[1]Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai,University&Affiliated Cancer Hospital of Qinghai University,Xining,Qinghai 810000,China

出　　处：《Cancer Pathogenesis and Therapy》2024年第2期81-90,共10页癌症发生与治疗（英文）

摘　　要：Background:Metastatic triple-negative breast cancer(mTNBC)is an aggressive histological subtype with poor prognosis.Several first-line treatments are currently available for mTNBC.This study conducted a network meta-analysis to compare these first-line regimens and to determine the regimen with the best efficacy.Methods:A systematic search of PubMed,EMBASE,the Cochrane Central Register of Controlled Bases,and mi-nutes of major conferences was performed.Progression-free survival(PFS),overall survival(OS),and objective response rate(ORR)were analyzed via network meta-analysis using the R software(R Core Team,Vienna,Austria).The efficacy of the treatment regimens was compared using hazard ratios and 95%confidence intervals.Results:A total of 29 randomized controlled trials involving 4607 patients were analyzed.The ranking was based on the surface under the cumulative ranking curve.Network meta-analysis results showed that cisplatin combined with nab-paclitaxel or paclitaxel was superior to docetaxel plus capecitabine in terms of PFS and ORR.For programmed death-ligand 1(PD-L1)and breast cancer susceptibility gene(BRCA)mutation-positive tumors,atezolizumab/pembrolizumab combined with nab-paclitaxel and talazoparib was superior to docetaxel plus capecitabine.No significant difference was observed among the treatments in Os.Neutropenia,diarrhea,and fatigue were common serious adverse events.Conclusion:Cisplatin combined with nab-paclitaxel or paclitaxel is the preferred first-line treatment for mTNBC.For PD-L1 and BRCA mutation-positive tumors,atezolizumab/pembrolizumab combined with nab-paclitaxel and talazoparib is an effective treatment option,Neutropenia,diarrhea,and fatigue are frequently occurring serious adverseevents.

关 键 词：Metastatictriple-negativebreast cancer First-line treatment CHEMOTHERAPY Immune-checkpoint inhibitors Poly(ADP-Ribose)polymerase inhibitors AKT inhibitor Networkmeta-analysis 

分 类 号：R737.9[医药卫生—肿瘤]