Effectiveness of Hormonal Therapy for Post-Menopausal Women with Hormone Receptor-Positive Advanced Breast Cancer: A Systematic Review and Meta-Analysis of Clinical Trials.

IF 2.2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medical Principles and Practice Pub Date : 2025-03-17 DOI:10.1159/000545264

Vitalis C Okwor, Juliet C Okwor, Maryjane K Ukwuoma, Sara B Mitha, Martins C Nweke

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引用次数: 0

Abstract

Objective: Breast cancer (BC) cells exhibit mutations over time, conferring resistance to therapeutic approaches. We attempted to ascertain the efficacy of selected hormonal therapy for advanced BC.

Methods: This is a systematic review and meta-analysis of clinical trials. We searched Medline, PubMed, Cochrane Library, Web of Science, and others. Studies that investigated the effectiveness of hormonal therapy for HR positive (HR+) advanced BC were included. The outcomes were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). A random-effect meta-analysis model was employed. The study protocol was registered with the International Prospective Register of Systematic Reviews: CRD42023431939.

Results: Twenty-one studies were included in the meta-analysis with an overall sample size of 8,482. ORR and PFS between aromatase inhibitors (AIs) and other hormonal therapies: selective oestrogen receptor degrader, selective oestrogen modulator (SERM) and androgen inhibitors showed no significant difference (OR = 1.122 [0.917-1.374], p = 0.263; OR = 0.010 [0.000-1.292], p = 0.063), respectively. Subgroup analysis showed a statistically significant difference in ORR in favour of patients who received SERM compared to AI (OR = 1.362 [1.033-1.795], p = 0.028). For OS, no significant difference was observed among anastrozole, letrozole, and exemestane recepients (OR = 1.718 [0.021-139.128], p = 0.809).

Conclusion: Given the above findings, clinical decisions could be based on factors such as the line of cancer treatment, adverse events, drug dosing, and individual drug benefits. Although newer combination therapies are being adopted, the agents explored in this review are still widely used in clinical practice for HR+ BC.

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激素治疗绝经后妇女激素受体阳性晚期乳腺癌的有效性：临床试验的系统回顾和荟萃分析。

目的：乳腺癌（BC）细胞随着时间的推移表现出突变，从而对治疗方法产生耐药性。我们试图确定选定的激素治疗晚期BC的疗效。方法：这是一项临床试验的系统综述和荟萃分析。我们搜索了Medline， PubMed, Cochrane Library， Web of Science等。研究了激素治疗HR+晚期BC的有效性。结果为无进展生存期（PFS）、总生存期（OS）和客观缓解率（ORR）。采用随机效应荟萃分析模型。该研究方案已在国际前瞻性系统评价注册中注册：CRD42023431939。结果：meta分析共纳入21项研究，总样本量为8482。芳香化酶抑制剂（AI）与其他激素疗法：选择性雌激素受体降解剂（SERD）、选择性雌激素调节剂（SERM）和雄激素抑制剂之间的ORR和PFS差异无统计学意义[OR = 1.122 (0.917-1.374), p = 0.263]；[OR = 0.010 (0.000-1.292), p = 0.063]。亚组分析显示，与AI相比，接受SERM治疗的患者的ORR有统计学差异[OR = 1.362 (1.033-1.795), p = 0.028]。在OS方面，阿那曲唑、来曲唑和依西美坦患者的OS差异无统计学意义[OR = 1.718 (0.021-139.128), p = 0.809]。结论：基于上述发现，临床决策可以基于诸如癌症治疗路线、不良事件、药物剂量和个体药物获益等因素。虽然新的联合疗法正在被采用，但本综述中探讨的药物仍广泛用于HR+ BC的临床实践。

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

Medical Principles and Practice 医学-医学：内科

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Medical Principles and Practice'', as the journal of the Health Sciences Centre, Kuwait University, aims to be a publication of international repute that will be a medium for dissemination and exchange of scientific knowledge in the health sciences.