The clinical impact of plasma estrogen receptor-1 mutation in patients with metastatic breast cancer: A meta-analysis.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Clinical and Experimental Medicine Pub Date : 2024-10-01 DOI:10.17219/acem/175816

Xiaoli Zhang, Ye Tian, Dan Mo, Wenli Chen, Yi Ding, Yanjiang Yang, Xinning Li

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引用次数: 0

Abstract

Background: The relevance of the discovered plasma ESR1 mutations in positive metastatic breast cancer (BC) patients who had progressing disease after aromatase inhibitor (AI)-based therapy is still being debated.

Objectives: We conducted this meta-analysis to explore the prognostic and predictive role of plasma ESR1 mutations in patients with progressive BC who have previously received AI therapy.

Material and methods: We searched for relevant studies in the PubMed, Embase and Cochrane Library databases to be included in the meta-analysis. This study was performed to compute combined hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the progression-free survival (PFS) rate and overall survival (OS) rate. Subgroup and sensitivity analyses were also performed. The heterogeneity between studies was evaluated using the I2 statistic.

Results: In this meta-analysis, a total of 1,844 patients with metastatic BC and positive for estrogen receptors (ERs) were enrolled from 8 articles. The analysis revealed that patients with circulating ESR1 mutations had significantly worse PFS (HR: 1.34; 95% CI: 1.17-1.55; p < 0.001) and OS (HR: 1.59; 95% CI: 1.31-1.92; p < 0.001) compared to wild-type ESR1 patients. Subgroup analysis showed that the types of plasma ESR1 mutations were associated with differences in the prognosis of metastatic BC. The D538G mutation showed a statistically significant lower PFS (p = 0.03), while the Y537S mutation was not significantly correlated with PFS (p = 0.354).

Conclusion: According to the findings of this meta-analysis, the assessment for plasma ESR1 mutations may provide prognostic and clinical guidance regarding subsequent endocrine therapy decisions for ER-positive, metastatic BC patients who had received prior therapy with AIs.

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转移性乳腺癌患者血浆雌激素受体-1突变的临床影响：荟萃分析

背景：在接受芳香化酶抑制剂（AI）治疗后病情进展的阳性转移性乳腺癌（BC）患者中发现的血浆ESR1突变的相关性仍存在争议：我们进行了这项荟萃分析，以探讨血浆ESR1突变在既往接受过芳香化酶抑制剂治疗的进展期BC患者中的预后和预测作用：我们在PubMed、Embase和Cochrane图书馆数据库中搜索了相关研究，以纳入荟萃分析。本研究计算了无进展生存率（PFS）和总生存率（OS）的合并危险比（HRs）及95%置信区间（95% CIs）。此外，还进行了亚组分析和敏感性分析。研究间的异质性采用I2统计量进行评估：在这项荟萃分析中，8篇文章共纳入了1844名雌激素受体（ER）阳性的转移性BC患者。分析结果显示，与野生型ESR1患者相比，循环ESR1突变患者的PFS（HR：1.34；95% CI：1.17-1.55；p < 0.001）和OS（HR：1.59；95% CI：1.31-1.92；p < 0.001）明显较差。亚组分析显示，血浆ESR1突变类型与转移性BC预后的差异有关。D538G突变显示较低的PFS（p = 0.03），具有统计学意义，而Y537S突变与PFS无显著相关性（p = 0.354）：根据这项荟萃分析的结果，血浆ESR1突变的评估可为ER阳性、转移性BC患者的后续内分泌治疗决策提供预后和临床指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.