Effect of metformin on progression-free survival outcomes in patients with advanced or metastatic HR+, HER2– breast cancer: subgroup analysis of STEPAUT

The Breast ◽  
2017 ◽  
Vol 32 ◽  
pp. S26-S27
Author(s):  
D. Egle ◽  
C. Marth ◽  
G. Steger ◽  
R. Bartsch ◽  
G. Pfeiler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Subgroup Analysis ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Free Survival ◽  
Her2 Breast Cancer ◽  
Breast Cancer Subgroup

Efficacy of Metformin in Patients With Breast Cancer Receiving Chemotherapy or Endocrine Therapy: Systematic Review and Meta-analysis

2021 ◽  
pp. 106002802110257
Author(s):  
Kayoko Morio ◽  
Yasuko Kurata ◽  
Nobuko Kawaguchi-Sakita ◽  
Akihiro Shiroshita ◽  
Yuki Kataoka
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Endocrine Therapy ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Recurrent Breast Cancer ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Evaluation Approach

Background Previous studies have suggested that metformin might improve survival outcomes in patients with breast cancer. However, findings on the efficacy of metformin with chemotherapy or endocrine therapy are inconsistent. Objective To clarify the efficacy of metformin with chemotherapy or endocrine therapy in breast cancer patients according to the treatment setting, including neoadjuvant, adjuvant, and metastasis/recurrence. Methods We systematically searched for randomized controlled trials (RCTs) in MEDLINE, CENTRAL, and EMBASE from inception through July 2020. Overall survival (OS), progression-free survival (PFS), and hypoglycemia rate were the primary outcomes. Secondary outcomes included severe adverse events (SAEs) and relapse-free survival. We used the Grading of Recommendations Assessment, Development, and Evaluation approach and performed a meta-analysis to evaluate the efficacy and safety of metformin with chemotherapy and endocrine therapy in patients with breast cancer. Results Our systematic review included 412 participants from 5 trials. Metformin showed little to no difference in OS (hazard ratio [HR] = 1.13; 95% CI = 0.71-1.81; certainty of evidence [COE], moderate) and PFS (HR = 1.14; 95% CI = 0.86-1.50; COE, moderate) in patients with metastasis/recurrence. The evidence was very uncertain about the effect of metformin on survival outcomes in patients who received metformin with neoadjuvant or adjuvant treatment. Metformin showed little to no difference in hypoglycemia and SAEs. Conclusion and Relevance Metformin should be discouraged routinely in nondiabetic patients with metastatic/recurrent breast cancer. Further RCTs are needed to verify whether metformin with chemotherapy or endocrine therapy results in significant clinical benefits in the neoadjuvant or adjuvant setting.

Network meta-analysis of adjuvant chemotherapy in early breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12071-e12071
Author(s):  
Preethi John ◽  
Raveendhara R Bannuru ◽  
Joshua T. Cohen ◽  
Rachel J. Buchsbaum ◽  
John Kalil Erban
Keyword(s):  
Breast Cancer ◽  
Randomized Clinical Trials ◽  
Early Stage ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Free Survival ◽  
Dose Dense ◽  
Optimal Regimen ◽  
Better Than

e12071 Background: The NCCN recommends several adjuvant regimens for early stage breast cancer (ESBC) that have not been directly compared in randomized clinical trials (RCTs) making the optimal regimen unclear. Regimens of interest include dose dense doxorubicin/cyclophosphamide followed by paclitaxel (DDAC-T), doxorubicin/cyclophosphamide followed by weekly paclitaxel (ACwkT), docetaxel/doxorubicin/cyclophosphamide (TAC), and docetaxel/cyclophosphamide (TC) x 4 cycles. This is the first network meta-analysis (NMA) to compare the effectiveness of these regimens. Methods: A systematic literature review was performed to identify RCTs that included the above regimens. To complete the network, doxorubicin/cyclophosphamide (AC), doxorubicin/cyclophosphamide followed by paclitaxel (AC-T) every 3 wks, and doxorubicin/cyclophosphamide followed by docetaxel (AC-D) every 3 wks were included. Primary outcomes were progression free survival (PFS) and overall survival (OS) estimated as odds ratios (OR). OR > 1 indicates better survival. Bayesian random effects model with non-informative priors was used. Results: 5 RCTs involving 12,579 females with mainly node positive, Her2- ESBC were analyzed. Although there were no statistically significant differences in PFS or OS among these regimens, AC-D, ACwkT, DDAC-T, TAC, and TC demonstrated better survival outcomes compared to AC and AC-T (not shown). Survival outcomes among DDAC-T, ACwkT, TAC, and TC were comparable. DDAC-T survival outcomes were marginally better than the other regimens. Conclusions: DDAC-T, ACwkT, TC, and TAC were similar in efficacy. Final results with at least one additional RCT will be presented. Although NMA is not a substitute for direct comparison RCTs, it allows indirect comparisons to aid in decision making. Future results from ongoing RCTs will refine estimates of anthracycline vs non anthracycline efficacy and toxicity. [Table: see text]

Immediate and long-term results of the first line chemotherapy in patients with metastatic triple negative breast cancer. Final analysis of randomized study

2020 ◽  
pp. 75-80
Author(s):  
S.A. Lyalkin ◽  
◽  
L.A. Syvak ◽  
N.O. Verevkina ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Randomized Study ◽  
Progression Free Survival ◽  
First Line ◽  
Free Survival ◽  
Group 2 ◽  
Line Chemotherapy ◽  
Group 1

The objective: was to evaluate the efficacy of the first line chemotherapy in patients with metastatic triple negative breast cancer (TNBC). Materials and methods. Open randomized study was performed including 122 patients with metastatic TNBC. The efficacy and safety of the first line chemotherapy of regimens АТ (n=59) – group 1, patients received doxorubicine 60 мг/м2 and paclitaxel 175 мг/м2 and ТР (n=63) – group 2, patients received paclitaxel 175 мг/м2 and carboplatin AUC 5 were evaluated. Results. The median duration of response was 9.5 months (4.5–13.25 months) in patients received AT regimen and 8.5 months (4.7–12.25 months), in TP regimen; no statistically significant differences were observed, р=0.836. The median progression free survival was 7 months (95% CI 5–26 months) in group 1 and 7.5 months (95% CI 6–35 months) in group 2, p=0.85. Both chemotherapy regimens (AT and TP) had mild or moderate toxicity profiles (grade 1 or 2 in most patients). No significant difference in gastrointestinal toxicity was observed. The incidence of grade 3–4 neutropenia was higher in patients of group 2 (TP regimen): 42.8% versus 27% (р<0.05). Conclusions. Both regimens of chemotherapy (AT and TP) are appropriate to use in the first line setting in patients with metastatic TNBC. Key words: metastatic triple negative breast cancer, chemotherapy, progression free survival, chemotherapy toxicity.

scholarly journals Phase II study of metronomic treatment with daily oral vinorelbine as first-line chemotherapy in patients with advanced/metastatic HR+/HER2− breast cancer resistant to endocrine therapy: VinoMetro—AGO-B-046

2021 ◽  
Author(s):  
Slavomir Krajnak ◽  
Thomas Decker ◽  
Lukas Schollenberger ◽  
Christian Rosé ◽  
Christian Ruckes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
First Line ◽  
Open Label ◽  
Oral Vinorelbine ◽  
Her2 Breast Cancer ◽  
Line Chemotherapy

Abstract Purpose Metronomic chemotherapy (MCT) is an increasingly used treatment option in hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced/metastatic breast cancer (MBC) after failure of endocrine-based therapies. Methods VinoMetro was a multicentre, open-label, single-arm, phase II study of metronomic oral vinorelbine (VRL; 30 mg/day) as a first-line chemotherapy (CT) in patients with HR+/HER2− MBC after endocrine failure. The primary endpoint was the clinical benefit rate (CBR) at 24 weeks. Results Between January 2017 and April 2019, nine patients were enrolled. The CBR was 22.2% (90% confidence interval [CI] 4.1–55.0), p = 0.211. The median progression-free survival (PFS) was 12.0 weeks (95% CI 11.3–12.7). Grade 3–4 adverse events (AEs) occurred in 22.2% of patients. One patient died of febrile neutropenia. Conclusion VinoMetro (AGO-B-046) was closed early after nine patients and occurrence of one grade 5 toxicity in agreement with the lead institutional review board (IRB). Metronomic dosing of oral VRL in HR+/HER2− MBC as first-line CT after failure of endocrine therapies showed only limited benefit in this population. Trial registration number and date of registration ClinicalTrials.gov Identifier: NCT03007992; December 15, 2016.

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