Multitargeted antiangiogenic tyrosine kinase inhibitors combined to chemotherapy in metastatic breast cancer: a systematic review and meta-analysis.

Purpose: We undertook a meta-analysis of randomized trials to evaluate the efficacy of multitargeted antiangiogenic tyrosine kinase inhibitors (MATKIs) in addition to chemotherapy in metastatic breast cancer. Methods: PubMed, Web of Knowledge databases and the ASCO meeting abstracts were searched fo...

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Published in:European Journal of Clinical Pharmacology Vol. 70; no. 5; pp. 531 - 539
Main Authors: Wang, Zexing, Wang, Meiqi, Yang, Fei, Nie, Weiwei, Chen, Fengxia, Xu, Jing, Guan, Xiaoxiang
Format: meta analysis research systematic review tables/charts Journal Article
Published: Springer Nature May2014
Online Access:View this record in EBSCOhost
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      dt: May2014
      vid: 70
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      pub: Springer Nature
      place: New York, New York
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        atl: Multitargeted antiangiogenic tyrosine kinase inhibitors combined to chemotherapy in metastatic breast cancer: a systematic review and meta-analysis.
      aug:
        au:
          Wang, Zexing
          Wang, Meiqi
          Yang, Fei
          Nie, Weiwei
          Chen, Fengxia
          Xu, Jing
          Guan, Xiaoxiang
        affil: Department of Pediatrics, Wangjiang People's Hospital, Wangjiang 246200 People's Republic of China
      sug:
        subj:
          Breast Neoplasms Drug Therapy
          Neoplasm Metastasis Drug Therapy
          Chemotherapy, Cancer Utilization
          Treatment Outcomes
          Protein Kinase Inhibitors Therapeutic Use
          Systematic Review
          Human
          Meta Analysis
          PubMed
          Odds Ratio
          Confidence Intervals
          Survival Analysis
          Descriptive Statistics
          Data Analysis Software
          Models, Statistical
          Funding Source
      ab: Purpose: We undertook a meta-analysis of randomized trials to evaluate the efficacy of multitargeted antiangiogenic tyrosine kinase inhibitors (MATKIs) in addition to chemotherapy in metastatic breast cancer. Methods: PubMed, Web of Knowledge databases and the ASCO meeting abstracts were searched for eligible literature published up to August 30, 2013. The endpoints included progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and toxicities. Pooled hazard ratios (HRs) for survival outcomes and odds ratio (ORs) for dichotomous data with 95 % confidence intervals (CIs) were derived. Results: Eight studies including 2,077 participants were analyzed. Compared to chemotherapy alone, adding MATKIs to chemotherapy resulted in a 14 % risk reduction of PFS events. However, the benefit did not reach statistical significance (HR 0.86; 95 % CI 0.70-1.04, P = 0.126). Also, no OS benefit was observed (HR 1.03; 95 % CI 0.89-1.18, P = 0.724). The addition of MATKIs significantly increased the ORR (OR 1.57; 95 % CI 1.30-1.91, P = 0.000). Subgroup analysis revealed that sorafinib showed a significantly greater effect on PFS in patients with HER2 negative metastatic breast cancer (HR 0.67; 95 % CI 0.55-0.82, P = 0.000) in comparison to chemotherapy alone. Additionally, sunitinib seemed to have no substantial efficacy for metastatic breast cancer. Toxicities were more frequent in patients receiving MATKIs. Conclusion: Overall, regimens consisting of MATKIs seemed not to be superior to chemotherapy alone in terms of PFS and OS, although significant improvement in ORR was observed. However, the addition of sorafenib significantly improved PFS. Further studies are needed to corroborate this finding.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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