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Intra-Arterial Therapies for Liver Metastatic Breast Cancer: A Systematic Review and Meta-Analysis
B M Aarts1,2, F M Gómez Muñoz3,4, H Wildiers5
1Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. b.aarts@nki.nl.
Cardiovascular and Interventional Radiology
|July 29, 2021
Summary
Transarterial radioembolization (TARE) and transarterial chemoembolization (TACE) show higher response rates than chemo-infusion for liver metastatic breast cancer (LMBC). TARE and TACE are recommended for chemorefractory LMBC patients.
Area of Science:
- Oncology
- Interventional Radiology
- Medical Imaging
Background:
- Liver metastatic breast cancer (LMBC) presents a significant clinical challenge.
- Intra-arterial therapies offer localized treatment options for LMBC.
- Evidence on the comparative efficacy of different intra-arterial therapies in LMBC is evolving.
Purpose of the Study:
- To systematically review and meta-analyze the evidence for intra-arterial therapies in patients with LMBC.
- To assess the response rates, adverse events, and survival outcomes associated with these therapies.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and SCOPUS for studies published between 2010 and 2020.
- Inclusion of studies with at least 10 LMBC patients and available outcome data.
- Pooled analysis of response rates using generalized linear mixed models and estimation of median overall survival.
Main Results:
- 26 studies (1266 patients) were included, focusing on transarterial radioembolization (TARE), transarterial chemoembolization (TACE), and chemo-infusion.
- Pooled response rates: TARE 49%, TACE 34%, chemo-infusion 19%.
- Pooled median survival: TARE 9.2 months, TACE 17.8 months, chemo-infusion 7.9 months; direct survival comparison was not possible due to heterogeneity.
Conclusions:
- TARE and TACE demonstrate superior response rates compared to chemo-infusion in LMBC patients.
- TARE or TACE are suggested as first-line options for chemorefractory LMBC.
- Chemo-infusion may be considered for patients unsuitable for TARE or TACE.
