医学
阿替唑单抗
肿瘤科
彭布罗利珠单抗
奥拉帕尼
内科学
不利影响
乳腺癌
转移性乳腺癌
荟萃分析
随机对照试验
软膜
免疫疗法
癌症
化学
聚ADP核糖聚合酶
基因
聚合酶
生物化学
作者
John Leung,Yun-sheng Tai,Shyh-Yau Wang,Ho Tsung-chin,Fion Hei-Tung Yip,Agnes L. F. Chan,Yu-chen Hsu
标识
DOI:10.1080/14740338.2022.2116001
摘要
Background Several therapies directed at novel targets and also immunotherapies have recently shown promising results in advanced or metastatic TNBC. We aimed to compare the efficacy and safety of these new regimens for advanced or metastatic TNBC (mTNBC).Methods The PubMed, Embase, and Cochrane Library electronic databases were searched for phase III randomized trials. We conducted a network meta-analysis to compare the efficacy and safety of new targeted and immunotherapy regimens. Trial quality was assessed using the GRADE method. The comparative outcomes were progression-free survival, overall survival, and G3–4 adverse drug events (ADEs).Results Thirteen phase III randomized controlled trials were identified in the network meta-analysis. Olaparib significantly improved PFS in comparison with the pembrolizumab plus chemotherapy 1, atezolizumab plus nab-paclitaxel and pembrolizumab regimens. Sacituzumab yielded a significant improvement in OS over immunotherapies, veliparib, and chemotherapy alone, but no significantly superiority over pembrolizumab, olaparib, and talazoparib. The risk of ≥grade 3 ADEs associated with olaparib was significantly lower than the risks associated with the other regimens.Conclusion For mTNBC, sacituzumab had a better effect on overall survival, with comparatively high risk of SAE, whereas olaparib improved progression-free survival with a lower risk of SAE, particularly in those patients with BRCA mutations.
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