A comparison of fulvestrant plus a targeted agent with fulvestrant alone in hormone receptor-positive advanced breast cancer that progressed on prior endocrine therapy: a meta-analysis

Xu, Liang; Yan, Ningning; Li, Zhihua; Luo, Lihua; Wu, Xiaobo; Liu, Qiuming; Xu, Yuanfan; Cao, Yimei

doi:10.2147/ott.s166653

Cited by 6 publications

(7 citation statements)

References 41 publications

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“…Although a number of studies have shown that CDK4/6 inhibitors added to ET is associated with a significant increase in PFS, OS of patients undergoing this treatment is unclear. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 Several recent randomized clinical trials have shown that treatment with CDK4/6 inhibitors and ET compared with ET alone increased OS among patients with HR-positive, ERBB2 -negative metastatic breast cancer. 22 , 23 , 24 , 25 , 26 However, other randomized clinical trials have found that treatment of patients with HR-positive, ERBB2 -negative metastatic breast cancer with CDK4/6 inhibitors and ET, compared with ET alone, does not prolong OS.…”

Section: Introductionmentioning

confidence: 99%

Association of Cyclin-Dependent Kinases 4 and 6 Inhibitors With Survival in Patients With Hormone Receptor–Positive Metastatic Breast Cancer

Huo

Zhao

et al. 2020

JAMA Netw Open

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IMPORTANCE One of the most recent treatment regimens used for hormone receptor (HR)positive, ERBB2 (formerly HER2)-negative metastatic breast cancer is treatment with the cyclindependent kinases 4 and 6 (CDK4/6) inhibitors and endocrine therapy (ET). OBJECTIVE To assess overall survival (OS), progression-free survival (PFS), objective response rate, and adverse events, especially grades 3 and 4 adverse events, among patients with HR-positive, ERBB2-negative metastatic breast cancer who were treated with CDK4/6 inhibitors plus ET vs ET alone. DATA SOURCES A systematic search of PubMed, Embase, the main oncology conference of the European Society of Medical Oncology, and the American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium databases for randomized clinical trials of CDK4/6 inhibitors plus ET vs ET for HR-positive, ERBB2-negative metastatic breast cancer. Searches were performed up to March 30, 2020. STUDY SELECTION A total of 472 records were assessed in PubMed and Embase by 2 authors, including studies, international meeting reports, and reviews. Inclusion criteria were Englishlanguage phase 2 or 3 randomized clinical trials of HR-positive, ERBB2-negative metastatic breast cancer, with patients randomly assigned to receive CDK4/6 inhibitors plus ET or ET alone, and having OS or PFS outcomes. The exclusion criteria were phase 1 trials, retrospective studies, or studies without survival outcomes. Excluding the references, 16 articles were relevant. After excluding studies based on exclusion criteria, 9 studies were considered eligible for this meta-analysis. DATA EXTRACTION AND SYNTHESIS Two researchers independently extracted data and assessed potential bias. Data assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. The results were pooled using a fixed-effect model. MAIN OUTCOMES AND MEASURES Study heterogeneity was assessed using the I 2 statistic. Hazard ratios (HRs) and 95% CIs were used to evaluate PFS, OS, and subgroup analyses. Overall response and 95% CIs were used to evaluate the objective response rate and grade 3 or 4 adverse events. The primary outcome was OS. RESULTS In total, 9 studies that included a total of 5043 patients with metastatic breast cancer were assessed in this meta-analysis.

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Section: Introductionmentioning

confidence: 99%

Association of Cyclin-Dependent Kinases 4 and 6 Inhibitors With Survival in Patients With Hormone Receptor–Positive Metastatic Breast Cancer

Huo

Zhao

et al. 2020

JAMA Netw Open

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“…Extracted information are as following: 1) first author' name, year of publication, origin country, tumor type, sample size, follow-up months, cut-off value, clinical TNM stage, detection and survival analysis method; 2) HRs or ORs with 95% CI of BCAR4 for overall survival (OS), progression-free survival (PFS), DFS, recurrence-free survival (RFS), lymph node metastasis (LNM) and distant metastasis (DM). If only Kaplan-Meier curves were provided in certain studies, the survival rates were indirectly extracted from the graphical plots and calculated HRs with 95% CIs were determined by using Engauge Digitizer software (Version 4.1) as previously described 35. Moreover, best efforts were made by contacting the corresponding author to obtaining the possible data if they were not available from the enrolled articles.…”

Section: Methodsmentioning

confidence: 99%

The Value of LncRNA BCAR4 as a Prognostic Biomarker on Clinical Outcomes in Human Cancers

Tu¹,

Ren²,

He³

et al. 2019

J. Cancer

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Background: This updated meta-analysis aimed to analyze available data to explore the prognostic value of long noncoding RNA breast cancer anti-estrogen resistance 4 (BCAR4) in various human malignancies. Methods: Literature retrieval was performed by systematic searching several authoritative databases, including Pubmed, PMC database, Web of Science, the Cochrane Library, Embase, and CNKI database up to Feb 10, 2019. Data were extracted and subsequently crosschecked, and discrepancies were discussed to reach consensus. Quality of the eligible studies was evaluated by Newcastle-Ottawa Scale (NOS). The fixed-or random-effects model was used to calculate the pooled the hazard ratios (HRs) or odds ratios (ORs) and the 95% confidence interval (95% CI). Publication bias was detected by using Begg's funnel plot and Egger's test. Results: A total 1,128 cancer patients from thirteen studies were included and pooled in the present meta-analysis. High expression levels of BCAR4 were correlated with unfavorable overall survival (OS) (HR=2.23, 95% CI: 1.84-2.71), but not progression-free survival (PFS) (HR=1.30, 95% CI: 0.80-2.11). Subgroup stratified analysis showed that tumor type, sample size, follow-up months, and survival analysis method did not alter the predictive value of BCAR4 on OS in various cancers. Furthermore, elevated BCAR4 level was markedly correlated with advanced clinical stage (III/IV) (OR=3.28, 95% CI: 2.33-4.60), and dramatically predicted lymph node metastasis (OR=3.00, 95% CI: 1.95-4.63, P<0.00001) and distant metastasis (OR=3.36, 95% CI: 1.88-5.98, P<0.0001), but not associated with age, gender or tumor size. No obvious heterogeneity was noted for correlation between BCAR4 expression and OS across these studies. Conclusions: High expression of BCAR4 was correlated with unfavorable overall survival outcome and clinical features including metastasis and progression, implicating an independent prognostic value for BCAR4 in human cancers.

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“…If data of interest were not accessible, we obtained the missing data by contacting the corresponding author of enrolled articles. If only Kaplan-Meier (K–M) curves were provided in some studies, we used the Engauge Digitizer (Version 4.1) to calculate the pooled HRs and 95% CIs through indirect extraction from the plots [33].…”

Section: Methodsmentioning

confidence: 99%

The prognostic value of long noncoding RNA SNHG16 on clinical outcomes in human cancers: a systematic review and meta-analysis

Zhang

Ren

et al. 2019

Cancer Cell Int

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Background: Cancer has been a worldwide health problem with a high risk of morbidity and mortality, however ideal biomarkers for effective screening and diagnosis of cancer patients are still lacking. Small nucleolar RNA host gene 16 (SNHG16) is newly identified lncRNA with abnormal expression in several human malignancies. However, its prognostic value remains controversial. This meta-analysis aimed to synthesize available data to clarify the association between SNHG16 expression levels and clinical prognosis value in multiple cancers. Methods: Extensive literature retrieval was conducted to identify eligible studies, and data regarding SNHG16 expression levels on survival outcomes and clinicopathological features were extracted and pooled for calculation of the hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs). Forest plots were applied to show the association between SNHG16 expression and survival prognosis. Additionally, The Cancer Genome Atlas (TCGA) dataset was screened and extracted for validation of the results in this meta-analysis. Results: A total of eight studies comprising 568 patients were included in the final meta-analysis according to the inclusion and exclusion criteria. In the pooled analysis, high SNHG16 expression significantly predicted worse overall survival (OS) in various cancers (HR = 1.87, 95% CI 1.54-2.26, P < 0.001), and recurrence-free survival (RFS) in bladder cancer (HR = 1.68, 95% CI 1.01-2.79, P = 0.045). Meanwhile, stratified analyses revealed that the survival analysis method, tumor type, sample size, and cutoff value did not alter the predictive value of SNHG16 for OS in cancer patients. In addition, compared to the low SNHG16 expression group, patients with high SNHG16 expression were more prone to worse clinicopathological features, such as larger tumor size, advanced clinical stage, lymph node metastasis (LNM) and distant metastasis (DM). Exploration of TCGA dataset further validated that the upregulated SNHG16 expression predicted unfavorable OS and disease-free survival (DFS) in cancer patients. Conclusions: The present study implicated that aberrant expression of lncRNA SNHG16 was strongly associated with clinical survival outcomes in various cancers, and therefore might serve as a promising biomarker for predicting prognosis of human cancers.

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A comparison of fulvestrant plus a targeted agent with fulvestrant alone in hormone receptor-positive advanced breast cancer that progressed on prior endocrine therapy: a meta-analysis

Cited by 6 publications

References 41 publications

Association of Cyclin-Dependent Kinases 4 and 6 Inhibitors With Survival in Patients With Hormone Receptor–Positive Metastatic Breast Cancer

Association of Cyclin-Dependent Kinases 4 and 6 Inhibitors With Survival in Patients With Hormone Receptor–Positive Metastatic Breast Cancer

The Value of LncRNA BCAR4 as a Prognostic Biomarker on Clinical Outcomes in Human Cancers

The prognostic value of long noncoding RNA SNHG16 on clinical outcomes in human cancers: a systematic review and meta-analysis

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