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Comparative efficacy of different targeted therapies plus fulvestrant for advanced breast cancer following

Tingting Zhang1, Fubin Feng2, Wenge Zhao3

  • 1College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People's Republic of China.

Cancer Management and Research
|December 5, 2018
PubMed
Abstract

Insights

Palbociclib plus fulvestrant shows superior progression-free survival compared to other targeted agents for advanced hormone-receptor-positive breast cancer. This combination may be the optimal choice for postmenopausal women after endocrine therapy progression.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Advanced breast cancer (ABC) treatment requires effective therapies post-endocrine resistance.
  • Hormone-receptor-positive (HR+) and human epidermal growth factor receptor type 2-negative (HER2-) subtypes represent a significant patient population.
  • Identifying optimal targeted agents combined with fulvestrant is crucial for improving patient outcomes.

Purpose of the Study:

  • To conduct a network meta-analysis comparing targeted agents plus fulvestrant against fulvestrant alone.
  • To evaluate the efficacy of palbociclib plus fulvestrant versus alternative targeted therapies in HR+/HER2- ABC.
  • To determine the optimal treatment strategy for patients progressing on prior endocrine therapy.

Main Methods:

  • Network meta-analysis of randomized controlled trials (RCTs) sourced from PubMed, EMBASE, and Cochrane Library.
  • Primary efficacy endpoints included progression-free survival (PFS) and objective response rate (ORR).
  • Surface Under the Cumulative Ranking (SUCRA) analysis was used to rank treatment effectiveness.

Main Results:

  • Palbociclib plus fulvestrant demonstrated superior PFS compared to pictilisib and buparlisib plus fulvestrant (HR=0.62).
  • Ribociclib plus fulvestrant showed no significant difference compared to abemaciclib or palbociclib plus fulvestrant.
  • Abemaciclib, dovitinib, buparlisib, and palbociclib plus fulvestrant significantly improved ORR compared to placebo plus fulvestrant.

Conclusions:

  • Palbociclib plus fulvestrant emerges as a potentially optimal treatment for HR+/HER2- advanced breast cancer patients.
  • This combination offers a promising therapeutic option for postmenopausal women experiencing disease progression after endocrine therapy.
  • Further research may validate these findings and guide personalized treatment approaches.
Keywords:
advanced breast cancerendocrine therapynetwork meta-analysisobjective response rateprogression-free survivaltargeted therapy

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