scholarly journals What is the Current Effectiveness of Olaparib for Breast Cancer Patients with a BRCA Mutation? A Systematic Review

2019 ◽  
Vol 13 (1) ◽  
pp. 39-59
Author(s):  
Polly Marsh ◽  
Graham R Williamson

Background:The Poly (ADP-ribose) polymerase inhibitor olaparib, acts against cancer cells in people with breast cancer pre-disposition gene mutations (BRCAm). Despite US and EU approval as a therapy for ovarian cancer patients with BRCAm, but research into olaparib therapy for breast cancer patients with BRCAm is in its infancy.Objective:As no systematic review has yet been undertaken to synthesise clinical trials looking at olaparib as a therapy for breast cancer patients with BRCAm, this systematic review aims to establish the current effectiveness of olaparib as a treatment for these patients.Methods:CINAHL, MEDLINE, Royal College of Nursing, Cochrane Library, Joanna Briggs Institute, Centre for Reviews and Dissemination, Internurse, Embase, Google Scholar and PubMed databases were searched, supplemented by a grey literature search, hand searching and cross-referencing. Authors independently reviewed and graded the studies also using Kmetet al. scoring system.Results:One long-term case study and six clinical trials were included. Heterogeneity prevented statistical meta-analysis, meaning only narrative synthesis was possible. The overall clinical benefit of olaparib appears to be greater and longer lived in BRCAm carriers compared to BRCAwt, and also when compared to standard chemotherapy treatments.Conclusion:Implications for nursing: nurses working in this field should be aware that the most compelling results were found in the subset of patients who harbour a BRCA mutation, meaning that olaparib should be regarded as a clinically effective potential therapy for these patients. Larger, longer-term trials including comparator arms are required to demonstrate benefits including overall survival, adverse effects and quality of life.

The Breast ◽  
2019 ◽  
Vol 44 ◽  
pp. 135-143 ◽  
Author(s):  
Liliana Coutiño-Escamilla ◽  
Maricela Piña-Pozas ◽  
Aurelio Tobías Garces ◽  
Brenda Gamboa-Loira ◽  
Lizbeth López-Carrillo

Author(s):  
Mahasti Alizadeh ◽  
Morteza Ghojazadeh ◽  
Reza Piri ◽  
Mohammad Mirza-Aghazadeh-Attari ◽  
Sahar Mohammadi ◽  
...  

Background: Breast cancer is responsible for up to 25% of all cancers in Iran. The age at diagnosis of Iranian breast cancer patients starts a decade earlier than most of developed countries. This study aimed to evaluate the mean age at diagnosis of Iranian breast cancer patients. Methods: In this systematic review and meta-analysis, the mean age at diagnosis of Iranian breast cancer patients and its pattern between 2008 and 2017, were evaluated. All papers with age at diagnosis of histopathological verified breast cancer patients were considered eligible to enter to the analysis. We used databases including Medline/PubMed, Scopus, Embase, Cochrane Library, Iranmedex and SID for the search process. The meta-analysis was performed only on studies with separate data for female patients, using random-effects model, Mantel and Haenszel method and the Comprehensive Meta-analysis software. Results: Finally, 92 studies with 19,784 patients (both-genders) were included. The mean age at diagnosis had increased from 47.93 (2008) to 49.91 (2016) years. The meta-analysis was done on 78 studies containing of 15,071 female patients and the mean age at diagnosis was 46.76±1.19. There was a wide range of age at diagnosis within different provinces. The mean age at Hamadan and Khuzestan provinces were the lowest and highest, respectively (42.48±7.96 vs. 51.00±11.47). The heterogeneity of studies was statistically significant (I2=99.744). Conclusion: Mean age at diagnosis of Iranian women with breast cancer was 46.76±1.19. There was an increasing pattern in mean age of diagnosis at breast cancer patients within the past 10 years.


Breast Care ◽  
2021 ◽  
pp. 1-9
Author(s):  
Henrique de Araújo Vianna Träsel ◽  
Frederico Soares Falcetta ◽  
Fernando Kude de Almeida ◽  
Mariana Rangel Ribeiro Falcetta ◽  
Rodrigo Antonini Ribeiro ◽  
...  

Purpose: Randomized clinical trials (RCT) are inconclusive regarding the role of dietary interventions in anthropometric measurements and survival in breast cancer patients. Our aim was to conduct a systematic review and meta-analysis to assess the effects of diet on these outcomes in women treated for early-stage breast cancer. Methods: Embase, MEDLINE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched for RCT comparing dietary interventions (individualized dietary counseling, prescription of a specific diet, or others) with usual care in women that were treated for early breast cancer. Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcome was a change in body mass index (BMI). Results: We found 12 RCT eligible for analysis, 7 of which were included in the quantitative analysis. Two studies reported OS and DFS and 6 reported BMI data. The hazard ratio (HR) for OS and DFS was 0.91 (95% confidence interval [CI] 0.77–1.07, p = 0.25) and 0.92 (95% CI 0.79–1.08, p = 0.31) for the intervention and control groups, respectively. Intervention was associated with BMI reduction in subjects who received a specific diet instead of counseling or other types of intervention (–0.67; 95% CI –1.14 to –0.21). Conclusions: Despite increasing survival among breast cancer patients due to better oncological treatments, there is still a lack of prospective data regarding the effects of dietary interventions in this population. We found positive association between prescription of specific diets in terms of anthropometric measures; there were no differences in OS or DFS.


BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Shamshirian ◽  
Amir Reza Aref ◽  
George W. Yip ◽  
Majid Ebrahimi Warkiani ◽  
Keyvan Heydari ◽  
...  

Abstract Background Measurement of serum human epidermal growth factor receptor-2 (HER-2/neu) levels might play an essential role as a diagnostic/screening marker for the early selection of therapeutic approaches and predict prognosis in breast cancer patients. We aimed to undertake a systematic review and meta-analysis focusing on the diagnostic/screening value of serum HER-2 levels in comparison to routine methods. Methods We performed a systematic search via PubMed, Scopus, Cochrane-Library, and Web of Science databases for human diagnostic studies reporting the levels of serum HER-2 in breast cancer patients, which was confirmed using the histopathological examination. Meta-analyses were carried out for sensitivity, specificity, accuracy, area under the ROC curve (AUC), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Results Fourteen studies entered into this investigation. The meta-analysis indicated the low sensitivity for serum HER2 levels (Sensitivity: 53.05, 95%CI 40.82–65.28), but reasonable specificity of 79.27 (95%CI 73.02–85.51), accuracy of 72.06 (95%CI 67.04–77.08) and AUC of 0.79 (95%CI 0.66–0.92). We also found a significant differences for PPV (PPV: 56.18, 95%CI 44.16–68.20), NPV (NPV: 76.93, 95%CI 69.56–84.31), PLR (PLR: 2.10, 95%CI 1.69–2.50) and NLR (NLR: 0.58, 95%CI 0.44–0.71). Conclusion Our findings revealed that although serum HER-2 levels showed low se nsitivity for breast cancer diagnosis, its specificity, accuracy and AUC were reasonable. Hence, it seems that the measurement of serum HER-2 levels can play a significant role as a verification test for initial negative screening test results, especially in low-income regions due to its cost-effectiveness and ease of implementation.


BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033461
Author(s):  
Kyeore Bae ◽  
Si Yeon Song

IntroductionAromatase inhibitor-induced arthralgia (AIA) is a major adverse event of aromatase inhibitors (AIs) and leads to premature discontinuation of AI therapy in breast cancer patients. The objective of this protocol for a systematic review and network meta-analysis (NMA) is to provide the methodology to compare the change in pain intensity between different AIA treatments and demonstrate the rank probabilities for different treatments by combining all available direct and indirect evidence.Methods and analysisPubMed, the Cochrane Controlled Register of Trials (CENTRAL), EMBASE, Web of Science and ClinicalTrials.gov will be searched to identify publications in English from inception to November 2019. We will include randomised controlled trials (RCTs) assessing the effects of different treatments for AIA in postmenopausal women with stage 0–III hormone receptor-positive breast cancer. The primary endpoints will be the change in patient-reported pain intensity from baseline to post-treatment. The number of adverse events will be presented as a secondary outcome.Both pairwise meta-analysis and NMA with the Frequentist approach will be conducted. We will demonstrate summary estimates with forest plots in meta-analysis and direct and mixed evidence with a ranking of the treatments as the P-score in NMA. The revised Cochrane risk-of-bias tool for randomised trials will be used to assess the methodological quality within individual RCTs. The quality of evidence will be assessed.Ethics and disseminationAs this review does not involve individual patients, ethical approval is not required. The results of this systematic review and NMA will be published in a peer-reviewed journal. This review will provide valuable information on AIA therapeutic options for clinicians, health practitioners and breast cancer survivors.PROSPERO registration numberCRD42019136967.


2021 ◽  
Vol 32 ◽  
pp. S43-S44
Author(s):  
K.S. Harborg ◽  
R. Zachariae ◽  
J. Olsen ◽  
M. Johannsen ◽  
D. Cronin-Fenton ◽  
...  

Oncotarget ◽  
2016 ◽  
Vol 7 (9) ◽  
pp. 10373-10385 ◽  
Author(s):  
Weige Tan ◽  
Qian Li ◽  
Kai Chen ◽  
Fengxi Su ◽  
Erwei Song ◽  
...  

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaoli Hu ◽  
Yang Liu ◽  
Zhitong Bing ◽  
Qian Ye ◽  
Chengcheng Li

Owing to metastases and drug resistance, the prognosis of breast cancer is still dismal. Therefore, it is necessary to find new prognostic markers to improve the efficacy of breast cancer treatment. Literature shows a controversy between moesin (MSN) expression and prognosis in breast cancer. Here, we aimed to conduct a systematic review and meta-analysis to evaluate the prognostic relationship between MSN and breast cancer. Literature retrieval was conducted in the following databases: PubMed, Web of Science, Embase, and Cochrane. Two reviewers independently performed the screening of studies and data extraction. The Gene Expression Omnibus (GEO) database including both breast cancer gene expression and follow-up datasets was selected to verify literature results. The R software was employed for the meta-analysis. A total of 9 articles with 3,039 patients and 16 datasets with 2,916 patients were ultimately included. Results indicated that there was a significant relationship between MSN and lymph node metastases (P < 0.05), and high MSN expression was associated with poor outcome of breast cancer patients (HR = 1.99; 95% CI 1.73–2.24). In summary, there is available evidence to support that high MSN expression has valuable importance for the poor prognosis in breast cancer patients.Systematic Review Registrationhttps://inplasy.com/inplasy-2020-8-0039/.


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