Faculty Opinions recommendation of Bisphosphonates in the adjuvant setting of breast cancer therapy--effect on survival: a systematic review and meta-analysis.

Author(s):  
Ana Maria Gonzalez-Angulo
PLoS ONE ◽  
2013 ◽  
Vol 8 (8) ◽  
pp. e70044 ◽  
Author(s):  
Irit Ben-Aharon ◽  
Liat Vidal ◽  
Shulamith Rizel ◽  
Rinat Yerushalmi ◽  
Ofer Shpilberg ◽  
...  

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 548-548 ◽  
Author(s):  
Liath Vidal ◽  
Irit Ben-Aharon ◽  
Shulamith Rizel ◽  
Rinat Yerushalmi ◽  
Aaron Sulkes ◽  
...  

548 Background: The role of bisphosphonates (BP) in the adjuvant setting in breast cancer has been evaluated in several studies, yielding inconsistent evidence. We performed a systematic review and meta-analysis of all randomized controlled trials (RCTs) that evaluate the effects of BP treatment on survival in patients with early breast cancer in the adjuvant setting. Methods: RCTs that compared BP therapy in addition to the standard adjuvant therapy (cytotoxic or hormonal) with standard adjuvant therapy only were identified by searching the Cochrane Library, LILACS, MEDLINE databases and conference proceedings (12.2011). Hazard ratios (HRs) of overall survival (OS), disease-free survival (DFS) and relative risks of adverse events were estimated and pooled. All statistical tests were two-sided. Results: Thirteen trials met the inclusion criteria., among which are the two recently published abstracts of large scale RCTs (NSABP-B34, GAIN) evaluating a total of 15,762 patients. Ten trials reported the OS outcome. Meta-analysis revealed no statistically significant benefit for BP (HR 0.89, 95% CI = 0.79 to 1.01). Nine trials reported the DFS outcome. Meta-analysis revealed no statistically significant better DFS for the intervention (HR 0.95 (0.80-1.11)). Six trials reported DFS stratified upon menopausal status. Postmenopausal patients who were treated with BP therapy had statistically significant better DFS than the control group (HR 0.81(0.69-0.95)). In meta-regression, chemotherapy was negatively associated with HR of OS (coefficient, -0.23; standard error, 0.144). BP therapy resulted in less fractures in the intervention arm, but higher incidence of osteonecrosis of the jaw and pyrexia. Conclusions: Our meta-analysis indicates a positive effect for adjuvant BP on survival outcomes only in postmenopausal patients with breast cancer. Meta-regression appraised the effect of confounders such as chemotherapy, showed a negative association between chemotherapy use and the effect of bisphosphonates on survival. Further large scale RCTs are warranted to unravel the specific subgroups and adjuvant treatments that would benefit from the addition of BP in the adjuvant setting.


2021 ◽  
Vol 11 ◽  
Author(s):  
Yuzhu Zhang ◽  
Yang Sun ◽  
Dongmei Li ◽  
Xiaoyuan Liu ◽  
Chen Fang ◽  
...  

AbstractThe present systematic review and meta-analysis was undertaken to evaluate the effects of acupuncture in women with breast cancer (BC), focusing on patient-reported outcomes (PROs).MethodsA comprehensive literature search was carried out for randomized controlled trials (RCTs) reporting PROs in BC patients with treatment-related symptoms after undergoing acupuncture for at least four weeks. Literature screening, data extraction, and risk bias assessment were independently carried out by two researchers.ResultsOut of the 2, 524 identified studies, 29 studies representing 33 articles were included in this meta-analysis. At the end of treatment (EOT), the acupuncture patients’ quality of life (QoL) was measured by the QLQ-C30 QoL subscale, the Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES), the Functional Assessment of Cancer Therapy–General/Breast (FACT-G/B), and the Menopause-Specific Quality of Life Questionnaire (MENQOL), which depicted a significant improvement. The use of acupuncture in BC patients lead to a considerable reduction in the scores of all subscales of the Brief Pain Inventory-Short Form (BPI-SF) and Visual Analog Scale (VAS) measuring pain. Moreover, patients treated with acupuncture were more likely to experience improvements in hot flashes scores, fatigue, sleep disturbance, and anxiety compared to those in the control group, while the improvements in depression were comparable across both groups. Long-term follow-up results were similar to the EOT results.ConclusionsCurrent evidence suggests that acupuncture might improve BC treatment-related symptoms measured with PROs including QoL, pain, fatigue, hot flashes, sleep disturbance and anxiety. However, a number of included studies report limited amounts of certain subgroup settings, thus more rigorous, well-designed and larger RCTs are needed to confirm our results.


2020 ◽  
Author(s):  
AS Heimes ◽  
P Fries ◽  
N Stergiou ◽  
R Attariya ◽  
A Hasenburg ◽  
...  

Oncoreview ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 83-87
Author(s):  
Tomasz Jankowski ◽  
Monika Urbaniak

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