Efficacy and Safety of Immunochemotherapy in Advanced Triple-negative Breast Cancer: A Meta-analysis of Randomised Clinical Trials

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology Pub Date : 2025-02-06 DOI:10.1016/j.clon.2025.103783

J. Shen, X. Ye, H. Hou, Y. Wang

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引用次数: 0

Abstract

Aims

Based on the existing controversial clinical research results, this study conducted a comprehensive meta-analysis of relevant literature to clarify the benefits of immunochemotherapy (ICT)—which combines immune checkpoint inhibitors and chemotherapy (CT)—for patients with advanced triple-negative breast cancer (aTNBC).

Materilas and methods

A thorough literature search was conducted up to February 15, 2024. Subsequently, meta-analyses were performed to aggregate hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), odds ratios (ORs) for objective response rate (ORR) and relative risks (RRs) for adverse events (AEs).

Results

Six randomised clinical trials (RCTs) involving 3,105 patients met the inclusion criteria. In comparison with CT, ICT yielded significant enhancements in PFS (HR, 0.80; 95%CI: 0.73–0.87), OS (HR, 0.87; 95%CI: 0.80–0.96), and ORR (OR, 1.34; 95%CI: 1.15–1.55) in the intention-to-treat population. However, ICT also exhibited an increase in grade ≥3 AEs (RR, 1.11; 95%CI: 1.04–1.19) and severe AEs (RR, 1.40; 95%CI: 1.18–1.66). Subgroup analyses revealed that ICT significantly improved PFS (HR, 0.67; 95%CI: 0.58–0.77), OS (HR, 0.75; 95%CI: 0.64–0.87), and ORR (OR, 1.47; 95%CI: 1.16–1.84) within the PD-L1-positive subgroup, whereas no statistically significant differences were detected for PD-L1-negative population.

Conclusion

ICT demonstrates superior efficacy over conventional CT in the treatment of aTNBC, albeit accompanied by heightened toxicity. Notably, the assessment of PD-L1 status may serve as a valuable biomarker in discerning aTNBC patients who are particularly predisposed to derive benefit from ICT.

PROSPERO number

CRD42024513270.

查看原文本刊更多论文

免疫化疗治疗晚期三阴性乳腺癌的疗效和安全性：随机临床试验的荟萃分析

目的基于已有的有争议的临床研究结果，本研究对相关文献进行综合荟萃分析，阐明免疫化疗（ICT）联合免疫检查点抑制剂和化疗（CT）治疗晚期三阴性乳腺癌（aTNBC）患者的益处。材料与方法对文献进行了全面检索，截止到2024年2月15日。随后，进行荟萃分析，汇总无进展生存期（PFS）和总生存期（OS）的风险比（hr）、客观缓解率（ORR）的优势比（ORs）和不良事件（ae）的相对风险（rr）。结果6项随机临床试验（RCTs）纳入3105例患者，符合纳入标准。与CT相比，ICT显著增强了PFS (HR, 0.80；95%ci: 0.73-0.87), OS (hr, 0.87；95%CI: 0.80-0.96), ORR (OR, 1.34；95%CI: 1.15-1.55)。然而，ICT也表现出≥3级ae的增加(RR, 1.11；95%CI: 1.04-1.19)和严重ae (RR, 1.40；95%置信区间:1.18—-1.66)。亚组分析显示ICT显著改善PFS (HR, 0.67；95%ci: 0.58-0.77), OS (hr, 0.75；95%CI: 0.64-0.87), ORR (OR, 1.47；95%CI: 1.16-1.84)，而pd - l1阴性人群的差异无统计学意义。结论ict治疗aTNBC的疗效优于常规CT，但其毒性较高。值得注意的是，PD-L1状态的评估可以作为一种有价值的生物标志物，用于识别特别倾向于从ICT中获益的aTNBC患者。普洛斯彼罗numberCRD42024513270。

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

Clinical oncology 医学-肿瘤学

CiteScore

5.20

自引率

8.80%

发文量

332

审稿时长

40 days

期刊介绍： Clinical Oncology is an International cancer journal covering all aspects of the clinical management of cancer patients, reflecting a multidisciplinary approach to therapy. Papers, editorials and reviews are published on all types of malignant disease embracing, pathology, diagnosis and treatment, including radiotherapy, chemotherapy, surgery, combined modality treatment and palliative care. Research and review papers covering epidemiology, radiobiology, radiation physics, tumour biology, and immunology are also published, together with letters to the editor, case reports and book reviews.