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Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases
BACKGROUND: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus A...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296918/ https://www.ncbi.nlm.nih.gov/pubmed/32539858 http://dx.doi.org/10.1186/s12957-020-01907-7 |
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author | Xia, Lin-Yu Hu, Qing-Lin Zhang, Jing Xu, Wei-Yun Li, Xiao-Shi |
author_facet | Xia, Lin-Yu Hu, Qing-Lin Zhang, Jing Xu, Wei-Yun Li, Xiao-Shi |
author_sort | Xia, Lin-Yu |
collection | PubMed |
description | BACKGROUND: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC. METHODS: A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC. RESULTS: A total of nine studies involving 36,480 patients met the selection criteria. Among them, 10,728 (29.41%) received NACT, and 25,752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23–0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95% CI = 1.25–2.02; P = 0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95% CI = 0.54–1.34; P = 0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95% CI = 0.29–0.98; P = 0.04) and DFS (HR = 0.52; 95% CI = 0.29–0.94; P = 0.03), while the OS (HR = 1.18; 95% CI = 1.09–1.28; P < 0.0001) and DFS (HR = 2.36; 95% CI = 1.42–3.89; P = 0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. CONCLUSION: These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS, and it turns to be opposite when patients are receiving NACT with RD. |
format | Online Article Text |
id | pubmed-7296918 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72969182020-06-16 Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases Xia, Lin-Yu Hu, Qing-Lin Zhang, Jing Xu, Wei-Yun Li, Xiao-Shi World J Surg Oncol Research BACKGROUND: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC. METHODS: A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC. RESULTS: A total of nine studies involving 36,480 patients met the selection criteria. Among them, 10,728 (29.41%) received NACT, and 25,752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23–0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95% CI = 1.25–2.02; P = 0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95% CI = 0.54–1.34; P = 0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95% CI = 0.29–0.98; P = 0.04) and DFS (HR = 0.52; 95% CI = 0.29–0.94; P = 0.03), while the OS (HR = 1.18; 95% CI = 1.09–1.28; P < 0.0001) and DFS (HR = 2.36; 95% CI = 1.42–3.89; P = 0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. CONCLUSION: These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS, and it turns to be opposite when patients are receiving NACT with RD. BioMed Central 2020-06-15 /pmc/articles/PMC7296918/ /pubmed/32539858 http://dx.doi.org/10.1186/s12957-020-01907-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Xia, Lin-Yu Hu, Qing-Lin Zhang, Jing Xu, Wei-Yun Li, Xiao-Shi Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
title | Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
title_full | Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
title_fullStr | Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
title_full_unstemmed | Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
title_short | Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
title_sort | survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296918/ https://www.ncbi.nlm.nih.gov/pubmed/32539858 http://dx.doi.org/10.1186/s12957-020-01907-7 |
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