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Meta-Analysis
. 2014 Apr 15:12:95.
doi: 10.1186/1477-7819-12-95.

Meta-analysis on the association between pathologic complete response and triple-negative breast cancer after neoadjuvant chemotherapy

Kunpeng Wu, Qiaozhu Yang, Yi Liu, Aibing Wu  1 , Zhixiong Yang
Affiliations
Meta-Analysis

Meta-analysis on the association between pathologic complete response and triple-negative breast cancer after neoadjuvant chemotherapy

Kunpeng Wu et al. World J Surg Oncol. .

Abstract

Background: Triple-negative breast cancer (TNBC) is a special subtype of breast cancer that is characterized by poor prognosis, strong tumor invasion and a high pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC). The pCR rate is a prognostic factor for TNBC. We aimed to evaluate the relationship between pCR and TNBC after NAC and originally tried to identify factors related to achieving pCR for TNBC using a meta-analysis.

Methods: We systematically searched the literature for pCR and breast cancer after NAC and carefully identified eligibility criteria. The association between pCR and breast cancer subtypes was estimated using Review Manager, while pCR rates for TNBC and non-TNBC were determined using Meta-Analyst.

Results: This analysis included a total of 9,460 cases from 27 studies. The summary odds ratio estimating the relationship between pCR and breast cancer subtypes (TNBC vs non-TNBC) was 3.02 (95% confidence interval (CI), 2.66 to 3.42). The TNBC pCR rate was 28.9% (95% CI, 27.0 to 30.8%) and the non-TNBC was 12.5% (95% CI, 11.7 to 13.4%). From subgroup analyses, we identified the factors associated with the highest pCR rates for TNBC.

Conclusions: TNBC has a higher pCR rate than non-TNBC. In the NAC setting, these factors of platinum-containing, more than six cycles, four kinds of drugs, 16 weeks' treatment duration and sequential chemotherapy may contribute to increasing the pCR rate.

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Figures

Figure 1
Figure 1
Flow chart used to identify relevant literature. ER, estrogen receptor; pCR, pathologic complete response; PR, progesterone receptor.
Figure 2
Figure 2
Forest plot of odds ratio for achieving pCR after NAC between TNBC and non-TNBC. CI, confidence interval; TNBC, triple-negative breast cancer; M-H, Mantel–Haenszel method.
Figure 3
Figure 3
Forest plots of pooled percentage of achieving pCR after NAC for TNBC and non-TNBC groups. TNBC, triple-negative breast cancer.
Figure 4
Figure 4
Funnel plot for identifying publication bias in the relationship for achieving pCR between TNBC and non-TNBC. OR, odds ratio.
Figure 5
Figure 5
Funnel plot for identifying publication bias for the pooled pCR rates in TNBC and non-TNBC. TNBC, triple-negative breast cancer.
See this image and copyright information in PMC

References

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