Neoadjuvant immunotherapy and chemotherapy regimens for the treatment of high-risk, early-stage triple-negative breast cancer: a systematic review and network meta-analysis
Cortes J, Haiderali A, Huang M, Pan W, Schmid P, Akers KG, Park JE, Frederickson AM, Fasching P, O’Shaughnessy J (2023)
Publication Type: Journal article
Publication year: 2023
Journal
Book Volume: 23
Article Number: 792
Journal Issue: 1
DOI: 10.1186/s12885-023-11293-4
Abstract
Background: Patients with triple-negative breast cancer (TNBC) are generally younger and more likely to experience disease recurrence and have the shortest survival among all breast cancer patients. Recently, neoadjuvant delivery of the programmed cell death protein-1 inhibitor pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab was approved for patients with high-risk, early-stage TNBC, but this treatment regimen has not been evaluated in head-to-head trials with other neoadjuvant treatment regimens. Therefore, the objective of this study was to estimate the relative efficacy of neoadjuvant pembrolizumab + chemotherapy followed by adjuvant pembrolizumab versus other neoadjuvant treatments for early-stage TNBC through a systematic review and network meta-analysis (NMA). Methods: EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, conference abstracts, and clinical trial registries were searched for randomized controlled trials evaluating neoadjuvant treatments for early-stage TNBC. NMA was performed to estimate relative treatment effects among evaluated interventions. Results: Five trials met the inclusion criteria and were included in the NMA. The relative efficacy of neoadjuvant pembrolizumab + chemotherapy followed by adjuvant pembrolizumab was favorable to paclitaxel followed by anthracycline + cyclophosphamide in terms of pathologic complete response (pCR), event-free survival (EFS), and overall survival; paclitaxel + carboplatin followed by anthracycline + cyclophosphamide in terms of pCR and EFS; paclitaxel + bevacizumab followed by anthracycline + cyclophosphamide + bevacizumab in terms of pCR; and paclitaxel + carboplatin + veliparib followed by anthracycline + cyclophosphamide in terms of EFS. Conclusions: Neoadjuvant pembrolizumab + chemotherapy followed by adjuvant pembrolizumab confers benefits in response and survival outcomes versus alternative neoadjuvant treatments for early-stage TNBC.
Authors with CRIS profile
Involved external institutions
Merck & Co., Inc. / Merck Sharp & Dohme Corp (MSD)
United States (USA) (US)
Queen Mary, University of London
United Kingdom (GB)
Cardiovascular Research Foundation
United States (USA) (US)
PRECISIONheor
Canada (CA)
Baylor University Medical Center
United States (USA) (US)
United States (USA) (US)
Queen Mary, University of London
United Kingdom (GB)
Cardiovascular Research Foundation
United States (USA) (US)
PRECISIONheor
Canada (CA)
Baylor University Medical Center
United States (USA) (US)
How to cite
APA:
Cortes, J., Haiderali, A., Huang, M., Pan, W., Schmid, P., Akers, K.G.,... O’Shaughnessy, J. (2023). Neoadjuvant immunotherapy and chemotherapy regimens for the treatment of high-risk, early-stage triple-negative breast cancer: a systematic review and network meta-analysis. BMC Cancer, 23(1). https://dx.doi.org/10.1186/s12885-023-11293-4
MLA:
Cortes, Javier, et al. "Neoadjuvant immunotherapy and chemotherapy regimens for the treatment of high-risk, early-stage triple-negative breast cancer: a systematic review and network meta-analysis." BMC Cancer 23.1 (2023).
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