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.
基金:
Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81773828, 81273600]; Natural Science Foundation of Hebei ProvinceNatural Science Foundation of Hebei Province [C2011206145, C2018206297]; Key Project of Medical Science Research of Hebei Province [ZD20140163]; Research Project of Education Department, Hebei Province [ZD2016010]; Project Medical Science Research of Hebei Health and Family Planning Commission [20160402]; Research Project of Hebei Health and Family Planning Commission [20160234]
第一作者机构:[1]Hebei Med Univ, Dept Pharmacol, 361 Zhongshan East Rd, Shijiazhuang 050017, Hebei, Peoples R China[2]Hebei Med Univ, Dept Pharm, Hebei Childrens Hosp, Shijiazhuang, Hebei, Peoples R China
通讯作者:
通讯机构:[1]Hebei Med Univ, Dept Pharmacol, 361 Zhongshan East Rd, Shijiazhuang 050017, Hebei, Peoples R China[3]Hebei Med Univ, Dept Radiol, Hosp 4, 12 Jiankang Rd, Shijiazhuang 050011, Hebei, Peoples R China[*1]Department of Pharmacology, Hebei Medical University, 361, Zhongshan East Road, Shijiazhuang 050017, China[*2]Department of Radiology, The Fourth Hospital of Hebei Medical University, 12, Jiankang Road, Shijiazhuang 050011, China
推荐引用方式(GB/T 7714):
Dong Lei,Zhu Li-Na,Xie Bao-Jie,et al.Comparative Effectiveness of Taxane-Containing Regimens for Treatment of HER2-Negative Metastatic Breast Cancer: A Network Meta-analysis[J].PHARMACOTHERAPY.2019,39(12):1126-1136.doi:10.1002/phar.2344.
APA:
Dong, Lei,Zhu, Li-Na,Xie, Bao-Jie,Li, Ji-Bin,Ding, Tao...&Zhu, Zhong-Ning.(2019).Comparative Effectiveness of Taxane-Containing Regimens for Treatment of HER2-Negative Metastatic Breast Cancer: A Network Meta-analysis.PHARMACOTHERAPY,39,(12)
MLA:
Dong, Lei,et al."Comparative Effectiveness of Taxane-Containing Regimens for Treatment of HER2-Negative Metastatic Breast Cancer: A Network Meta-analysis".PHARMACOTHERAPY 39..12(2019):1126-1136