Regimens of neo-adjuvant chemotherapy in the treatment of breast cancer: A systematic review & network meta-analysis with PRISMA-NMA compliance

Mona Pathak, Suryanarayana VS Deo, Sada Nand Dwivedi, Bhaskar Thakur, Vishnubhatla Sreenivas, Goura Kishore Rath

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number103015
JournalCritical Reviews in Oncology/Hematology
Volume153
DOIs
StatePublished - Sep 2020
Externally publishedYes

Keywords

  • Anthracyclines
  • Bevacizumab
  • Breast cancer
  • Breast conserving surgery
  • Neo-adjuvant therapy
  • Pathological complete response
  • Taxanes
  • Trastuzumab

ASJC Scopus subject areas

  • Hematology
  • Oncology

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