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.

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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.