Meta-analysis of phase III trials of docetaxel alone or in combination with chemotherapy in metastatic breast cancer.
Meta-analysis of phase III trials of docetaxel alone or in combination with chemotherapy in metastatic breast cancer.
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DOI：
10.1007/s00432-011-1091-0
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发表时间：
2012-02
影响因子：
3.6
通讯作者：
Natoli, Clara
中科院分区：
文献类型：
--
作者：
Belfiglio, Maurizio;Fanizza, Caterina;Tinari, Nicola;Ficorella, Corrado;Iacobelli, Stefano;Natoli, Clara
联合化疗是否优于序贯治疗转移性乳腺癌（MBC）仍是一个悬而未决的问题。与不含紫杉烷类的方案相比，含紫杉烷类的多药化疗方案已被证明可增加总生存期（OS）、肿瘤进展时间（TTP）和总缓解率（ORR），而基于紫杉烷的双联方案仅在无进展生存期方面优于单药紫杉烷。然而，术语“紫杉烷类”通常包括紫杉醇和多西他赛，具有不同临床活性的药物。本研究的目的是使用正式的荟萃分析比较接受多西他赛单药治疗或多西他赛联合化疗治疗的MBC患者的OS、TTP和ORR。我们对所有已发表的比较多西他赛单用或与其他化疗药物联合治疗MBC的试验进行了系统评价。检索了3项随机临床试验，包括1，313例患者。与多西他赛单药治疗相比，化疗药物联合多西他赛治疗患者的TTP（P ≤ 0.0001）风险比显著降低，但OS（P = 0.48）或ORR（P = 0.10）风险比未显著降低。多西他赛单药治疗与3级腹泻和口腔炎的发生率较低相关（腹泻，P = 0.011;口腔炎，P = 0.0004）。多西他赛联合化疗方案对MBC的TTP显示出统计学显著优势，但对OS和ORR无统计学显著优势。这篇综述证实，由于MBC的异质性，任何单药或联合化疗方案都不太可能成为MBC的上级治疗方案。
Whether combination chemotherapy offers an advantage over sequential therapy in metastatic breast cancer (MBC) is still an unsettled issue. Polychemotherapy regimens containing taxanes has been shown to increase overall survival (OS), time to tumor progression (TTP), and overall response rate (ORR) when compared with regimens that did not contain a taxanes, while taxane-based doublets have a statistically significant benefit over single-agent taxane only for progression-free survival. However, the term “taxanes” generally includes both paclitaxel and docetaxel, drugs with different clinical activity. Aim of this work is to compare OS, TTP, and ORR in patients with MBC receiving docetaxel alone or in combination with chemotherapy using a formal meta-analysis. We performed a systematic review of all published trials comparing docetaxel alone or in combination with other chemotherapeutic agents in MBC. Three randomized clinical trials including 1,313 patients were retrieved. A significant reduction of risk ratio was found in TTP (P ≤ 0.0001) but not in OS (P = 0.48) or ORR (P = 0.10) for patients treated with a chemotherapy agent plus docetaxel compared with docetaxel alone. Treatment with docetaxel alone is associated with a lower incidence of grade 3 diarrhea and stomatitis (diarrhea, P = 0.011; stomatitis, P = 0.0004). Combination chemotherapy regimens with docetaxel show a statistically significant advantage for TTP, but not for OS and ORR in MBC. This review confirms that it is unlikely that any single agent or combination chemotherapy regimen will emerge as superior in MBC, due to its heterogeneous nature.
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DOI：
10.1093/jnci/djp235
发表时间：
2009-09-02
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Cardoso F;Bedard PL;Winer EP;Pagani O;Senkus-Konefka E;Fallowfield LJ;Kyriakides S;Costa A;Cufer T;Albain KS;ESO-MBC Task Force
通讯作者：
ESO-MBC Task Force
影响因子：
45.3
作者：
O'Shaughnessy, J;Miles, D;Leonard, R
通讯作者：
Leonard, R
影响因子：
10.3
作者：
Brewster, Abenaa M.;Hortobagyi, Gabriel N.;Esteva, Francisco J.
通讯作者：
Esteva, Francisco J.
影响因子：
2.4
作者：
Lin, Yung-Chang;Chang, Hsien-Kun;Liaw, Chaung-Chi
通讯作者：
Liaw, Chaung-Chi
影响因子：
50.5
作者：
Cardoso, F.;Senkus-Konefka, E.;Castiglione, M.
通讯作者：
Castiglione, M.