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Dong, Lei; Zhu, Li‐na; Xie, Bao‐jie; Li, Ji‐bin; Ding, Tao; Jiang, Yun‐fa; Zhu, Zhong‐ning
Pharmacotherapy, December 2019, 2019-12-00, 20191201, Letnik: 39, Številka: 12Journal Article
Study Objectives To compare the effectiveness of different taxane‐containing regimens and to identify the best strategy for the treatment of human epidermal growth factor receptor 2 (HER2)‐negative metastatic breast cancer (MBC). Design Network meta‐analysis of 20 randomized controlled trials (RCTs). Patients A total of 6577 patients with HER2‐negative MBC who received treatment (20 different regimens) with taxanes (paclitaxel 4267 patients or docetaxel 2310 patients). Measurements and Main Results The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched (through March 2019) for RCTs that evaluated any taxane‐containing regimens for the treatment of HER2‐negative MBC. A network meta‐analysis in a Bayesian framework was performed using the random‐effects model. We compared the surface under the cumulative ranking (SUCRA) curve for each regimen. Overall, paclitaxel‐based combinations were superior to paclitaxel alone in objective response rate (ORR) (odds ratio 1.60, 95% credible interval CrI 1.15–2.16) and overall survival (OS) (hazard ratio 1.08, 95% CrI 1.01–1.15). Docetaxel‐based combinations were also superior to paclitaxel alone in ORR. Among the paclitaxel‐based regimens, based on the results of SUCRA, paclitaxel + bevacizumab + capecitabine was likely to be the most efficacious in improving ORR, OS, and progression‐free survival (PFS), whereas paclitaxel + gemcitabine was likely to be the most efficacious in 1‐year OS rate. Among the docetaxel‐based regimens, based on the results of SUCRA, docetaxel + gemcitabine was likely to be the most efficacious in improving PFS and OS. Conclusion These findings demonstrated that paclitaxel‐based combinations can provide significant improvement in ORR and OS compared with paclitaxel alone. The regimens of paclitaxel + bevacizumab + capecitabine, docetaxel + gemcitabine, and paclitaxel + gemcitabine may be superior to other regimens for the treatment of HER2‐negative MBC.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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