Cancer Research and Treatment

Original Article

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

Citations to this article as recorded by

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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