First‑line endocrine therapy for hormone receptor positive and HER‑2 negative metastatic breast cancer: A Bayesian network meta‑analysis

Jiang,Yi-Cheng; Yang,Jing-Jing; Zhang,Hai-Tian; Zhuo,Rui; De La Roche,Sebastian; Torres‑De La Roche,Luz Angela; De Wilde,Rudy Leon; Dong,Jie

doi:10.3892/ol.2024.14646

First‑line endocrine therapy for hormone receptor positive and HER‑2 negative metastatic breast cancer: A Bayesian network meta‑analysis

Authors:
- Yi-Cheng Jiang
- Jing-Jing Yang
- Hai-Tian Zhang
- Rui Zhuo
- Sebastian De La Roche
- Luz Angela Torres‑De La Roche
- Rudy Leon De Wilde
- Jie Dong
View Affiliations

Affiliations: Department of Breast Surgery, EUSOMA Certified Breast Center, Guilin Traditional Chinese Medicine Hospital of China, Guilin, Guangxi Zhuang Autonomous Region 541002, P.R. China, Department of Neonates, Guilin People's Hospital, Guilin, Guangxi Zhuang Autonomous Region 541001, P.R. China, Department of Breast Disease, Guangxi International Zhuang Medical Hospital, Nanning, Guangxi Zhuang Autonomous Region 530001, P.R. China, International Max Planck Research School in Molecular Biology, Georg‑August‑University of Gottingen, D‑37077 Gottingen, Germany, Department of Gynecology, Pius Hospital, Carl von Ossietzky University, D‑26121 Oldenburg, Germany
Published online on: August 28, 2024 https://doi.org/10.3892/ol.2024.14646
Article Number: 513
Copyright : © Jiang et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Endocrine therapy has become the fundamental treatment option for hormone receptor‑positive (HR⁺) and receptor tyrosine‑protein kinase erbB‑2‑negative (HER2^‑) metastatic breast cancer (mBC). While treatments incorporating cyclin‑dependent kinase (CDK)4 and 6 inhibitors are more prevalent than ever, comparisons among those regimens are scarce. The aim of the present study was to identify the most effective maintenance treatment for patients with HR⁺ and HER2^‑ mBC. To this end, databases including PubMed, Embase, Cochrane Library, Scopus and Google Scholar were searched from inception to August, 2023. The endpoints comprised overall survival (OS) and progression free survival (PFS). For dichotomous variants, hazard ratios (HRs) and odds ratios (ORs) were generated, while standard mean difference (SMD) was used for consecutive variants by Bayesian network meta‑analysis to make pairwise comparisons among regimens, to determine the optimal therapy. These processes were conducted using Rstudio 4.2.2 orchestrated with STATA 17.0 MP. A total of 16 randomized controlled trials including 7,174 patients with 11 interventions were analyzed. Compared with aromatase inhibitor (AI), palbociclib plus AI (PalboAI) exhibited a significantly longer PFS up to the 36th month of follow‑up [HR=1.7; 95% credible interval, 1.36‑2.16], including on the 3rd [OR=2.22; 95% confidence interval (CI), 1.10‑4.47], 6th (OR=2.39; 95% CI, 1.21‑4.69), 12th (OR=1.94; 95% CI, 1.34‑2.79), 18th (OR=2.38; 95% CI, 1.65‑3.44), 24th (OR=2.39; 95% CI, 1.67‑3.43), 30th (OR=2.10; 95% CI, 1.62‑2.74) and 36th (OR=2.66; 95% CI, 1.37‑5.18) month of follow‑up. Additionally, abemaciclib plus fulvestrant exhibited significant effects compared with AI alone between 12 and 36 months. Ribociclib plus fulvestrant, ribociclib plus AI and dalpiciclib plus AI exerted significant effects compared with AI alone between 12 and 30 months. Considering the effect on OS and PFS together with adverse reactions, safety, medical compliance and route of administration, PalboAI was found to be the optimal treatment for HR⁺/HER2^‑mBC. However, additional head‑to‑head clinical trials are warranted to confirm these findings.