Endocrine-Based Treatments in Clinically-Relevant Subgroups of Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: Systematic Review and Meta-Analysis.

endocrine therapy hormone receptor meta-analysis metastatic breast cancer systematic review

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
22 Mar 2021
Historique:
received: 09 02 2021
revised: 09 03 2021
accepted: 17 03 2021
entrez: 3 4 2021
pubmed: 4 4 2021
medline: 4 4 2021
Statut: epublish

Résumé

A precise assessment of the efficacy of first-/second-line endocrine therapies (ET) ± target therapies (TT) in clinically-relevant subgroups of hormone receptor-positive (HR+)/HER2-negative metastatic breast cancer (MBC) has not yet been conducted. To improve our current knowledge and support clinical decision-making, we thus conducted a systematic literature search to identify all first-/second-line phase II/III randomized clinical trials (RCT) of currently approved or most promising ET ± TT. Then, we performed a meta-analysis to assess progression-free (PFS) and/or overall survival (OS) benefit in several clinically-relevant prespecified subgroups. Thirty-five RCT were included (17,595 patients). Pooled results show significant reductions in the risk of relapse or death of 26-41% and 12-27%, respectively, depending on the clinical subgroup. Combination strategies proved to be more effective than single-agent ET (PFS hazard ratio (HR) range for combinations: 0.60-0.65 vs. HR range for single agent ET: 0.59-1.37; OS HR range for combinations: 0.74-0.87 vs. HR range for single agent ET: 0.68-0.98), with CDK4/6-inhibitors(i) + ET being the most effective regimen. Single agent ET showed comparable efficacy with ET+TT combinations in non-visceral (

Identifiants

pubmed: 33810205
pii: cancers13061458
doi: 10.3390/cancers13061458
pmc: PMC8004645
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Subventions

Organisme : Italian Ministry of University and Research (MIUR)
ID : 2017EKMFTN_006
Organisme : European Society for Medical Oncology
ID : ESMO Fellowship 2020 - Translational

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Auteurs

Francesco Schettini (F)

Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy.
Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain.
SOLTI Breast Cancer Research Group, 08008 Barcelona, Spain.

Mario Giuliano (M)

Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy.

Fabiola Giudici (F)

Unit of Biostatistics, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy.

Benedetta Conte (B)

Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain.
Breast Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.

Pietro De Placido (P)

Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy.

Sergio Venturini (S)

Department of Management, University of Turin, 10124 Turin, Italy.
Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, 20136 Milan, Italy.

Carla Rognoni (C)

Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, 20136 Milan, Italy.

Angelo Di Leo (A)

"Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy.

Mariavittoria Locci (M)

Department of Neuroscience, Reproductive Medicine and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy.

Guy Jerusalem (G)

Medical Oncology Department, Centre Hospitalier Universitaire de Liège and Liège University, 4000 Liège, Belgium.

Lucia Del Mastro (L)

Breast Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132 Genoa, Italy.

Fabio Puglisi (F)

Department of Medicine, University of Udine, 33100 Udine, Italy.
IRCCS Centro di Riferimento Oncologico Aviano, National Cancer Institute, 33081 Aviano, Italy.

PierFranco Conte (P)

Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy.
Division of Medical Oncology 2, Istituto Oncologico Veneto-IRCCSS, 35128 Padova, Italy.

Michelino De Laurentiis (M)

Breast Oncology Unit, INT-Fondazione "G. Pascale", 80131 Naples, Italy.

Lajos Pusztai (L)

Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, USA.

Mothaffar F Rimawi (MF)

Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA.
Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.

Rachel Schiff (R)

Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA.
Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA.

Grazia Arpino (G)

Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy.

Sabino De Placido (S)

Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy.

Aleix Prat (A)

Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain.
SOLTI Breast Cancer Research Group, 08008 Barcelona, Spain.
Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain.

Daniele Generali (D)

Department of Medical, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy.
Breast Cancer Unit, Azienda Socio Sanitaria Territoriale di Cremona, 26100 Cremona, Italy.

Classifications MeSH