TY - JOUR
T1 - Regimens of neo-adjuvant chemotherapy in the treatment of breast cancer
T2 - A systematic review & network meta-analysis with PRISMA-NMA compliance
AU - Pathak, Mona
AU - Deo, Suryanarayana VS
AU - Dwivedi, Sada Nand
AU - Thakur, Bhaskar
AU - Sreenivas, Vishnubhatla
AU - Rath, Goura Kishore
N1 - Funding Information:
The authors thank All India Institute of Medical sciences (AIIMS), New Delhi, to make available the computer laboratory facility, library, online accessibility of articles and other resources.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/9
Y1 - 2020/9
N2 - Efficacy of neo-adjuvant therapy depends on the used regimens. There are contradictory findings regarding relative efficacy of these regimens. Accordingly, present study assessed the relative efficacy of Anthracyclines, Taxanes and added targeted therapies in neo-adjuvant setting simultaneously with a focus on tumor response and breast conserving surgery among breast cancer patients. The network meta-analysis model was used. Ranking of treatment was done by surface under cumulative ranking curve for each regimen. Out of 1286 screened records obtained by searching PubMed and Cochrane register of controlled trials, a total of 34 studies randomizing 12,630 breast cancer patients were included. Network meta-analysis for pathological complete response (pCR) revealed Addition of targeted therapies especially Trastuzumab for HER2+ breast cancer and Bevacizumab for HER2- breast cancer along with Anthracyclines and/or Taxanes based chemotherapy significantly improves pCR but with increased haematological toxicities. All the regimens performed similar in terms of breast conserving surgery rates.
AB - Efficacy of neo-adjuvant therapy depends on the used regimens. There are contradictory findings regarding relative efficacy of these regimens. Accordingly, present study assessed the relative efficacy of Anthracyclines, Taxanes and added targeted therapies in neo-adjuvant setting simultaneously with a focus on tumor response and breast conserving surgery among breast cancer patients. The network meta-analysis model was used. Ranking of treatment was done by surface under cumulative ranking curve for each regimen. Out of 1286 screened records obtained by searching PubMed and Cochrane register of controlled trials, a total of 34 studies randomizing 12,630 breast cancer patients were included. Network meta-analysis for pathological complete response (pCR) revealed Addition of targeted therapies especially Trastuzumab for HER2+ breast cancer and Bevacizumab for HER2- breast cancer along with Anthracyclines and/or Taxanes based chemotherapy significantly improves pCR but with increased haematological toxicities. All the regimens performed similar in terms of breast conserving surgery rates.
KW - Anthracyclines
KW - Bevacizumab
KW - Breast cancer
KW - Breast conserving surgery
KW - Neo-adjuvant therapy
KW - Pathological complete response
KW - Taxanes
KW - Trastuzumab
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U2 - 10.1016/j.critrevonc.2020.103015
DO - 10.1016/j.critrevonc.2020.103015
M3 - Review article
C2 - 32563131
AN - SCOPUS:85086606103
SN - 1040-8428
VL - 153
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
M1 - 103015
ER -