Cancer Research and Treatment

Original Articles

Breast cancer

Clinical Evidence of Chemotherapy or Endocrine Therapy Maintenance in Patients with Metastatic Breast Cancer: Meta-Analysis of Randomized Clinical Trials and Propensity Score Matching of Multicenter Cohort Study: Wei Ren, Yunfang Yu, Huangming Hong, Ying Wang, Quanlong Gao, Yongjian Chen, Peixian Chen, Jianli Zhao, Qiyun Ou, Dagui Lin, Tuping Fu, Yujie Tan, Chenchen Li, Xinxin Xie, Guolin Ye, Jun Tang, Herui Yao; Cancer Res Treat. 2022;54(4):1038-1052. Published online February 4, 2022; DOI: https://doi.org/10.4143/crt.2021.698

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Purpose
This study aims to comprehensively evaluate the clinical efficacy of chemotherapy or endocrine therapy maintenance in metastatic breast cancer (MBC) patients.
Materials and Methods
The meta-analysis of randomized clinical trials (RCTs) and propensity score matching of multicenter cohort study evaluated MBC patients who underwent first-line chemotherapy or endocrine therapy maintenance. This study is registered with PROSPERO: CRD42017071858 and ClinicalTrials.gov: NCT04258163.
Results
A total of 2,867 patients from 15 RCTs and 760 patients from multicenter cohort were included. The results from meta-analysis showed that chemotherapy maintenance improved progression-free survival (PFS) (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.54 to 0.73; p < 0.001; moderate-quality evidence) and overall survival (OS) (HR, 0.87; 95% CI 0.78 to 0.97; p=0.016; high-quality evidence) than observation. In the cohort study, for hormone receptor–positive MBC patients, chemotherapy maintenance improved PFS (HR, 0.67; 95% CI, 0.52 to 0.85; p < 0.001) and OS (HR, 0.55; 95% CI 0.42 to 0.73; p < 0.001) compared with observation, and endocrine therapy maintenance also improved PFS (HR, 0.65; 95% CI, 0.53 to 0.80; p < 0.001) and OS (HR, 0.55; 95% CI, 0.44 to 0.69; p < 0.001). There were no differences between chemotherapy and endocrine therapy maintenance in PFS and OS (all p > 0.05). Regardless of the continuum or switch maintenance therapy, showed prolonged survival in MBC patients who were response to first-line treatment.
Conclusion
This study provided evidences for survival benefits of chemotherapy and endocrine therapy maintenance in MBC patients, and there was no difference efficacy between chemotherapy and endocrine therapy maintenance for hormone receptor–positive patients.

Citations

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6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)
Fatima Cardoso, Shani Paluch-Shimon, Eva Schumacher-Wulf, Leonor Matos, Karen Gelmon, Matti S. Aapro, Jyoti Bajpai, Carlos H. Barrios, Jonas Bergh, Elizabeth Bergsten-Nordström, Laura Biganzoli, Maria João Cardoso, Lisa A. Carey, Mariana Chavez-MacGregor,
The Breast.2024; 76: 103756. CrossRef
Maintenance endocrine therapy plus bevacizumab for advanced or metastatic breast cancer
Stanislas Quesada, William Jacot
The Lancet Oncology.2022; 23(5): 557. CrossRef

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Dose-Dense Rituximab-CHOP versus Standard Rituximab-CHOP in Newly Diagnosed Chinese Patients with Diffuse Large B-Cell Lymphoma: A Randomized, Multicenter, Open-Label Phase 3 Trial: Xueying Li, He Huang, Bing Xu, Hongqiang Guo, Yingcheng Lin, Sheng Ye, Jiqun Yi, Wenyu Li, Xiangyuan Wu, Wei Wang, Hongyu Zhan, Derong Xie, Jiewen Peng, Yabing Cao, Xingxiang Pu, Chengcheng Guo, Huangming Hong, Zhao Wang, Xiaojie Fang, Yong Zhou, Suxia Lin, Qing Liu, Tongyu Lin; Cancer Res Treat. 2019;51(3):919-932. Published online October 2, 2018; DOI: https://doi.org/10.4143/crt.2018.230

Abstract PDF PubReader ePub

Purpose
Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population.
Materials and Methods
Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP- 14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities.
Results
Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21.
Conclusion
R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.

Citations

Citations to this article as recorded by

Prediction of 5‐year overall survival of diffuse large B‐cell lymphoma on the pola‐R‐CHP regimen based on 2‐year event‐free survival and progression‐free survival
Wan‐Ru Zhang, Xin Liu, Qiu‐Zi Zhong, Tao Wu, Yong Yang, Bo Chen, Hao Jing, Yuan Tang, Jing Jin, Yue‐Ping Liu, Yong‐Wen Song, Hui Fang, Ning‐Ning Lu, Ning Li, Yi‐Rui Zhai, Wen‐Wen Zhang, Shu‐Lian Wang, Fan Chen, Lin Yin, Shu‐Nan Qi, Ye‐Xiong Li
Cancer Medicine.2024;[Epub] CrossRef
Long-term outcomes with HLX01 (HanliKang®), a rituximab biosimilar, in previously untreated patients with diffuse large B-cell lymphoma: 5-year follow-up results of the phase 3 HLX01-NHL03 study
Yan Qin, Yongping Song, Dong Wang, Ou Bai, Jifeng Feng, Xiuhua Sun, Lihua Qiu, Jianmin Yang, Yu Yang, Zhao Wang, Jianda Hu, Huaqing Wang, Hang Su, Zhengming Jin, Wenbin Qian, Chuan Jin, Mingzhi Zhang, Ding Yu, Li Liu, Guoan Chen, Yarong Li, Tao Sun, Jie J
BMC Cancer.2024;[Epub] CrossRef
Palmitic acid reduces the methylation of the FOXO1 promoter to suppress the development of diffuse large B-cell lymphoma via modulating the miR-429/DNMT3A axis
Weiming LI, Ming GAO, Weili XUE, Xiaoli LI, Yu CHANG, Kaixin ZHANG, Chenyu WEN, Mingzhi ZHANG
Chinese Journal of Natural Medicines.2024; 22(6): 554. CrossRef
Prophylaxis forPneumocystis cariniipneumonia in non-Hodgkin’s lymphoma undergoing R-CHOP21 in China: a meta-analysis and cost-effectiveness analysis
Xiaojia Huang, Xiaoting Huang, Shen Lin, Shaohong Luo, Liangliang Dong, Dong Lin, Yaping Huang, Chen Xie, Dongni Nian, Xiongwei Xu, Xiuhua Weng
BMJ Open.2023; 13(3): e068943. CrossRef
Intensified First Cycle of Rituximab Plus Eight Cycles of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone with Rituximab Chemotherapy for Advanced-Stage or Bulky Diffuse Large B-Cell Lymphoma: A Multicenter Phase II Consortium for Improving S
Yu Ri Kim, Jin Seok Kim, Won Seog Kim, Hyeon Seok Eom, Deok-Hwan Yang, Sung Hwa Bae, Hyo Jung Kim, Jae Hoon Lee, Suk-Joong Oh, Sung-Soo Yoon, Jae-Yong Kwak, Chul Won Choi, Min Kyoung Kim, Sung Young Oh, Hye Jin Kang, Seung Hyun Nam, Hyeok Shim, Joon Seong
Cancer Research and Treatment.2023; 55(4): 1355. CrossRef
Radiation and Dose-densification of R-CHOP in Aggressive B-cell Lymphoma With Intermediate Prognosis: The UNFOLDER Study
Lorenz Thurner, Marita Ziepert, Christian Berdel, Christian Schmidt, Peter Borchmann, Dominic Kaddu-Mulindwa, Andreas Viardot, Mathias Witzens-Harig, Judith Dierlamm, Mathias Haenel, Bernd Metzner, Gerald Wulf, Eva Lengfelder, Ulrich B. Keller, Norbert Fr
HemaSphere.2023; 7(7): e904. CrossRef
Лечение пациентов с впервые диагностированной диффузной В-крупноклеточной лимфомой: систематический обзор и метаанализ
Александр Сергеевич Лучинин
Clinical Oncohematology.2022; 15(2): 130. CrossRef
The prognostic roles of hepatitis B virus antibody in diffuse large B-cell lymphoma patients
Shunfeng Hu, Na Chen, Kang Lu, Changqing Zhen, Xiaohui Sui, Xiaosheng Fang, Ying Li, Yingshu Luo, Xiangxiang Zhou, Xin Wang
Leukemia & Lymphoma.2021; 62(6): 1335. CrossRef
Primary diffuse large B-cell lymphoma of the fallopian tube treated with a combination of surgery and chemotherapy
Ye Zhou, Chao Zhang, Yingying Gong, Linqing Yang, Yunfei Wang
Medicine.2021; 100(3): e24049. CrossRef
Impact and Intricacies of Bone Marrow Microenvironment in B-cell Lymphomas: From Biology to Therapy
Anuvrat Sircar, Sayan Chowdhury, Amber Hart, William Bell, Satishkumar Singh, Lalit Sehgal, Narendranath Epperla
International Journal of Molecular Sciences.2020; 21(3): 904. CrossRef
Association of progression-free or event-free survival with overall survival in diffuse large B-cell lymphoma after immunochemotherapy: a systematic review
Jie Zhu, Yong Yang, Jin Tao, Shu-Lian Wang, Bo Chen, Jian-Rong Dai, Chen Hu, Shu-Nan Qi, Ye-Xiong Li
Leukemia.2020; 34(10): 2576. CrossRef
Front-Line Treatment of High Grade B Cell Non-Hodgkin Lymphoma
Murali Kesavan, Toby A. Eyre, Graham P. Collins
Current Hematologic Malignancy Reports.2019; 14(4): 207. CrossRef
Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
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Clinical oncohematology.2019; 12(4): 25. CrossRef

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