Comparison of mTOR inhibitors combined with endocrine therapy versus that alone in breast cancer: a meta-analysis.

IF 3 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2025-05-01 Epub Date: 2025-03-28 DOI:10.1080/14796694.2025.2485022

Wei Zhang, Xinru Jia, Dandi Lou, Qingping Wu, Yici Yan, Feiyan Mao

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引用次数: 0

Abstract

Background: This meta-analysis aims to evaluate the efficacy and safety of rapamycin (mTOR) inhibitors with endocrine therapy versus endocrine therapy alone in treating advanced or metastatic estrogen receptor/progesterone receptor (ER/PR) + breast cancer.

Methods: We conducted a comprehensive search in PubMed, Web of Science, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing mTOR inhibitors plus endocrine therapy with endocrine therapy alone up to September 2024.

Results: This analysis included 10 RCTs comprising 3,337 patients. Relative to endocrine therapy alone, the combination of mTOR inhibitors and endocrine therapy significantly improved the clinical benefit rate (RR = 1.41, p < 0.001), overall response rate (RR = 1.40, p = 0.006), progression-free survival (PFS; HR = 0.67, p < 0.001), and overall survival (OS; HR = 0.86, p = 0.056), although the improvement in OS was not statistically significant. Subgroup analyses indicated a more pronounced PFS advantage in patients under 65 years of age (HR = 0.55, p = 0.013) and those who had previously received chemotherapy (HR = 0.51, p = 0.001). However, the incidence of adverse events was higher in the combination therapy group, notably stomatitis (p < 0.001), elevated aspartate aminotransferase/alanine aminotransferase (p = 0.04), and diarrhea (p = 0.01).

Conclusions: The combination of mTOR inhibitors with endocrine therapy offers superior efficacy with manageable toxicities in patients with advanced or metastatic ER/PR+ breast cancer.

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mTOR抑制剂联合内分泌治疗与单独治疗乳腺癌的比较：荟萃分析。

背景：本荟萃分析旨在评价雷帕霉素（mTOR）抑制剂联合内分泌治疗与单独内分泌治疗治疗晚期或转移性雌激素受体/孕激素受体(ER/PR) +乳腺癌的疗效和安全性。方法：我们在PubMed， Web of Science， Embase和Cochrane图书馆中进行了全面的检索，以比较截至2024年9月mTOR抑制剂联合内分泌治疗与单独内分泌治疗的随机对照试验（rct）。结果：本分析纳入10项随机对照试验，共3337例患者。与单独内分泌治疗相比，mTOR抑制剂联合内分泌治疗显著提高了临床获益率（RR = 1.41, p = 0.006）、无进展生存期(PFS；HR = 0.67, p p = 0.056)，但OS改善无统计学意义。亚组分析显示，65岁以下患者（HR = 0.55, p = 0.013）和以前接受过化疗的患者（HR = 0.51, p = 0.001）的PFS优势更为明显。然而，联合治疗组不良事件的发生率较高，特别是口腔炎（p p = 0.04）和腹泻（p = 0.01）。结论：mTOR抑制剂联合内分泌治疗对晚期或转移性ER/PR+乳腺癌患者具有优越的疗效和可控的毒性。

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

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.