RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

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.

참고문헌 (Reference)

1 Sutherland S, "Use of maintenance endocrine therapy after chemotherapy in metastatic breast cancer" 69 : 216-222, 2016

2 Yu YF, "Trastuzumab combined with doublet or single-agent chemotherapy as first-line therapy for HER2-positive metastatic breast cancer" 168 : 337-348, 2018

3 Liberati A, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration" 151 : W65-W94, 2009

4 Westreich D, "Propensity score estimation : neural networks, support vector machines, decision trees(CART), and meta-classifiers as alternatives to logistic regression" 63 : 826-833, 2010

5 Zhao J, "Prognostic immune-related gene models for breast cancer : a pooled analysis" 10 : 4423-4433, 2017

6 Park YH, "Phase III, multicenter, randomized trial of maintenance chemothe-rapy versus observation in patients with metastatic breast cancer after achieving disease control with six cycles of gemcitabine plus paclitaxel as first-line chemotherapy : KCSG-BR07-02" 31 : 1732-1739, 2013

7 Eisenhauer EA, "New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)" 45 : 228-247, 2009

8 DerSimonian R, "Meta-analysis in clinical trials" 7 : 177-188, 1986

9 Higgins JP, "Measuring inconsistency in meta-analyses" 327 : 557-560, 2003

10 Alba E, "Maintenance treatment with pegylated liposomal doxorubicin versus observation following induction chemotherapy for metastatic breast cancer : GEICAM 2001-01 study" 122 : 169-176, 2010