Eficacy and safety of a combination treatment of immune checkpoint inhibitors in metastatic breast cancer: a systematic review and meta‑analysis

• Ying Wang ^[1] ; Yalan Sun ^[1] ; Fang Lu ^[1] ; Xianghong Zhao ^[1] ; Bangshun He ^[1] ; Zhenlin Nie ^[2] ; Feng Zhu ^[3]
  1. [1] China Pharmaceutical University

     China Pharmaceutical University

     China

     
  2. [2] Deparment of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China
  3. [3] Department of Laboratory Medicine, Nanjing Jiangning People’s Hospital, 68 Gushan Road, Jiangning District, Nanjing, Jiangsu 211100, China

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 7, 2024, págs. 1725-1737
• Idioma: inglés
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• Resumen

  • Purpose Immune checkpoint inhibitors (ICIs) in combination with chemotherapy have showed its benefts in clinical studies, and here we conducted a further evaluation on the safety and efcacy of this treatment strategy.

    Methods A systematic literature review was conducted in PubMed, Embase and Cochrane Library to identify clinical studies on ICIs and chemotherapy for metastatic breast cancer. The primary efcacy endpoints were progression-free survival (PFS) and overall survival (OS), and adverse events (AEs) were analyzed. Random or fxed efects models were used to estimate pooled Hazard ratio (HR), odds ratio (OR) and the data of 95% confdence interval (CI) depend on the Heterogeneity. Cochrane risk assessment tool was used to assess risk of bias. We also drew forest plots and funnel plots, respectively.

    Results Seven studies with intend-to-treat (ITT) population for 3255 patients were analyzed. ICIs pooled therapy showed clinical benefts compared with chemotherapy alone, improving PFS (HR =0.81, 95% CI: 0.74–0.90) of patients with metastatic triple negative breast cancer (mTNBC), especially in patients with PD-L1-positive tumors. However, it had no efect on OS (HR=0.92, 95% CI 0.85–1.01). Besides, mTNBC patients received pooled therapy were less frequently to have AEs (OR=1.30, 95% CI: 1.09–1.54). In patients with metastatic Human Epidermal Growth Factor Receptor 2 (HER2) negative breast cancer, pooled therapy showed no beneft for PFS (HR=0.80, 95% CI: 0.50–1.28) and OS (HR=0.87, 95% CI: 0.48–1.58).

    Conclusion Pooled therapy had improved PFS in mTNBC patients, especially in patients with PD-L1-positive tumors, and it was less likely to cause grade≥3 AEs.