激素受体阳性晚期乳腺癌一线治疗方案的疗效:一项信息论网状Meta分析  

Efficacy of first-line treatment regimens for hormone receptor-positive advanced breast cancer:an information theoretic network Meta-analysis

作　　者：孙庆凯 韩松甫 郭超洋 路伟平 陆佳 赵晗宇 王新帅[1] SUN Qingkai;HAN Songfu;GUO Chaoyang;LU Weiping;LU Jia;ZHAO Hanyu;WANG Xinshuai(Department of Breast Oncology,the First Affiliated Hospital/College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院/河南科技大学第一附属医院乳腺肿瘤内科,河南洛阳471003

出　　处：《现代医学》2025年第4期660-673,共14页Modern Medical Journal

摘　　要：目的:采用信息论网状Meta分析方法,对激素受体阳性晚期乳腺癌一线治疗方案的疗效进行评价。方法:检索PubMed、Embase、Cochrane数据库、中国知网、万方及维普数据库,搜集有关激素受体阳性晚期乳腺癌一线治疗的随机对照试验(RCT),检索时限均从建库至2024年8月27日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险。使用R 4.4.1软件进行信息论网状Meta分析。结果:共纳入72项RCT,涉及226733例患者及92种治疗方案。治疗方案包括内分泌治疗、化疗、靶向治疗及其组合。其中,靶向联合内分泌治疗的联合疗法排名靠前,如哌柏西利联合来曲唑排名第一;而一些传统的单药内分泌疗法如来曲唑或阿那曲唑,则排名靠后。结论:细胞周期蛋白依赖性激酶4/6抑制剂联合非甾体类芳香化酶抑制剂或氟维司群作为一线治疗方案优于其他方案。然而药物的选择需要临床医生结合实际情况,综合考虑疗效及安全性,制定个体化的治疗策略。Objective:To evaluate the efficacy of first-line treatment regimens for hormone receptor-positive advanced breast cancer using an information theoretic network Meta-analysis.Methods:PubMed,Embase,The Cochrane Library,CNKI,WanFang Data and VIP Databases were electronically searched to collect randomized controlled trials(RCTs)on the first-line treatment of hormone receptor-positive advanced breast cancer from inception to August 27th,2024.After two researchers independently screened the literature,extracted data,and evaluated the risk of bias in the included studies,information-theoretic network Meta-analysis was performed using the R 4.4.1 software.Results:A total of 72 RCTs involving 226733 patients were included,evaluating 92 treatment regimens categorized into endocrine therapy,chemotherapy,targeted therapy,and their combinations.Combination therapies integrating targeted agents with endocrine therapy demonstrated superior efficacy rankings,with the regimen of palbociclib combined with letrozole ranking first.In contrast,conventional endocrine monotherapies,such as anastrozole or letrozole alone,ranked lower in comparative efficacy analyses.Conclusion:The combination of cyclin dependent kinase 4/6 inhibitors with nonsteroidal aromatase inhibitors or fulvestrant demonstrates superior efficacy as first-line treatment regimens compared to other therapies.However,therapeutic agent selection necessitates clinicians to comprehensively evaluate both efficacy and safety profiles within specific clinical contexts,thereby formulating individualized treatment strategies.

关 键 词：雌激素受体 孕激素受体 晚期/转移乳腺癌 一线治疗 信息论网状Meta分析 

分 类 号：R737.9[医药卫生—肿瘤]