Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Dec;39(12):1126-1136.
doi: 10.1002/phar.2344. Epub 2019 Nov 24.

Comparative Effectiveness of Taxane-Containing Regimens for Treatment of HER2-Negative Metastatic Breast Cancer: A Network Meta-analysis

Lei Dong  1   2 , Li-Na Zhu  3 , Bao-Jie Xie  3 , Ji-Bin Li  4 , Tao Ding  5 , Yun-Fa Jiang  6 , Zhong-Ning Zhu  1
Affiliations
Comparative Study

Comparative Effectiveness of Taxane-Containing Regimens for Treatment of HER2-Negative Metastatic Breast Cancer: A Network Meta-analysis

Lei Dong et al. Pharmacotherapy. 2019 Dec.

Abstract

Study objectives: To compare the effectiveness of different taxane-containing regimens and to identify the best strategy for the treatment of human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC).

Design: Network meta-analysis of 20 randomized controlled trials (RCTs).

Patients: A total of 6577 patients with HER2-negative MBC who received treatment (20 different regimens) with taxanes (paclitaxel [4267 patients] or docetaxel [2310 patients]).

Measurements and main results: The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched (through March 2019) for RCTs that evaluated any taxane-containing regimens for the treatment of HER2-negative MBC. A network meta-analysis in a Bayesian framework was performed using the random-effects model. We compared the surface under the cumulative ranking (SUCRA) curve for each regimen. Overall, paclitaxel-based combinations were superior to paclitaxel alone in objective response rate (ORR) (odds ratio 1.60, 95% credible interval [CrI] 1.15-2.16) and overall survival (OS) (hazard ratio 1.08, 95% CrI 1.01-1.15). Docetaxel-based combinations were also superior to paclitaxel alone in ORR. Among the paclitaxel-based regimens, based on the results of SUCRA, paclitaxel + bevacizumab + capecitabine was likely to be the most efficacious in improving ORR, OS, and progression-free survival (PFS), whereas paclitaxel + gemcitabine was likely to be the most efficacious in 1-year OS rate. Among the docetaxel-based regimens, based on the results of SUCRA, docetaxel + gemcitabine was likely to be the most efficacious in improving PFS and OS.

Conclusion: These findings demonstrated that paclitaxel-based combinations can provide significant improvement in ORR and OS compared with paclitaxel alone. The regimens of paclitaxel + bevacizumab + capecitabine, docetaxel + gemcitabine, and paclitaxel + gemcitabine may be superior to other regimens for the treatment of HER2-negative MBC.

Keywords: docetaxel; metastatic breast cancer; network meta-analysis; paclitaxel; taxanes.

PubMed Disclaimer

References

    1. Puglisi F, Rea D, Kroes MA, Pronzato P. Second-line single-agent chemotherapy in human epidermal growth factor receptor 2-negative metastatic breast cancer: a systematic review. Cancer Treat Rev 2016;43:36-49.
    1. Park YH, Im SA, Kim SB, et al. Phase II, multicentre, randomised trial of eribulin plus gemcitabine versus paclitaxel plus gemcitabine as first-line chemotherapy in patients with HER2-negative metastatic breast cancer. Eur J Cancer 2017;86:385-93.
    1. Ma X, Wang X, Huang J, et al. Bevacizumab addition in neoadjuvant treatment increases the pathological complete response rates in patients with HER-2 negative breast cancer especially triple negative breast cancer: a meta-analysis. PLoS One 2016;11(8):e0160148.
    1. Mendes D, Alves C, Afonso N, et al. The benefit of HER2-targeted therapies on overall survival of patients with metastatic HER2-positive breast cancer-a systematic review. Breast Cancer Res 2015;17:140.
    1. Feng F, Zhang T, Yin F, et al. Efficacy and safety of targeted therapy for metastatic HER2-positive breast cancer in the first-line treatment: a Bayesian network meta-analysis. Onco Targets Ther 2019;12:959-74.

MeSH terms