Efficacy of vinorelbine-based neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis of randomized controlled trials

  • Authors:
    • Hui Gao
    • Qiuyun Li
    • Wei Wei
    • Yi Jiang
    • Huawei Yang
    • Jianlun Liu
  • View Affiliations

  • Published online on: June 9, 2015     https://doi.org/10.3892/mco.2015.576
  • Pages: 1145-1151
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Abstract

The present study aimed to compare the effects of vinorelbine-based neoadjuvant chemotherapy and vinorelbine-free regimens. A meta-analysis of all the relevant randomized controlled trials was performed to investigate the improvement in pathological complete response (pCR), overall response rate (ORR) and breast‑conserving surgery (BCS). The PubMed and Embase databases were searched for relevant studies reporting randomized controlled trials comparing vinorelbine‑based neoadjuvant chemotherapy with vinorelbine‑free regimens until July 2013. Risk ratios/odds ratio and 95% confidence intervals (CIs) were used to estimate the association between vinorelbine in neoadjuvant chemotherapy and various efficacy outcomes. Fixed‑ or random‑effect models were adopted to pool the data. Five eligible studies with a total of 1,495 patients were included in the meta‑analysis. Compared to vinorelbine‑free chemotherapy, vinorelbine‑based regimens demonstrated no significant improvement in clinical outcomes including: pCR [relative risk (RR)=1.016; 95% CI, 0.738‑1.399; P=0.922], ORR (RR=1.048; 95% CI, 0.969‑1.133; P=0.239) and BCS (RR=1.764; 95% CI, 0.734‑4.239; P=0.205). However, vinorelbine‑based regimens were associated with a lower incidence of grade 3‑4 alopecia (OR, 0.617; 95% CI, 0.448‑0.848; P=0.003). In a hierarchical analysis for patients who received neoadjuvant chemotherapy, the proportion of subjects achieving pCR was significantly increased when HER2‑amplified (RR=2.31; 95% CI, 1.20‑4.43; P=0.01) and hormone receptor negative (RR=0.488; 95% CI, 0.263‑0.908; P=0.023). The present review confirms that neoadjuvant chemotherapy vinorelbine‑based regimens are unlikely to emerge as superior to pCR, ORR and BCS. Hierarchical analysis indicated that the HER2‑amplified and hormone receptor‑negative patients were significantly associated with a pathological response rate.
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September-2015
Volume 3 Issue 5

Print ISSN: 2049-9450
Online ISSN:2049-9469

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Spandidos Publications style
Gao H, Li Q, Wei W, Jiang Y, Yang H and Liu J: Efficacy of vinorelbine-based neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis of randomized controlled trials. Mol Clin Oncol 3: 1145-1151, 2015
APA
Gao, H., Li, Q., Wei, W., Jiang, Y., Yang, H., & Liu, J. (2015). Efficacy of vinorelbine-based neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis of randomized controlled trials. Molecular and Clinical Oncology, 3, 1145-1151. https://doi.org/10.3892/mco.2015.576
MLA
Gao, H., Li, Q., Wei, W., Jiang, Y., Yang, H., Liu, J."Efficacy of vinorelbine-based neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis of randomized controlled trials". Molecular and Clinical Oncology 3.5 (2015): 1145-1151.
Chicago
Gao, H., Li, Q., Wei, W., Jiang, Y., Yang, H., Liu, J."Efficacy of vinorelbine-based neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis of randomized controlled trials". Molecular and Clinical Oncology 3, no. 5 (2015): 1145-1151. https://doi.org/10.3892/mco.2015.576