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Updated: Aug 16, 2025
Studying Triple Negative Breast Cancer Using Orthotopic Breast Cancer Model
Published on: March 20, 2020
Optimal Choice as First-Line Therapy for Patients with Triple-Negative Breast Cancer: A Bayesian Network
Yiqun Han1, Jiayu Wang1, Yun Wu1
1Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing 100021, China.
Abstract:
To identify the advantageous therapy as the first-line treatment for patients with triple-negative breast cancer (TNBC). Randomized controlled trials were searched for on Medline, Embase, ClinicalTrials.gov, and the Cochrane Library between January 2001 and December 2021. The primary endpoint was progression-free survival (PFS) and secondary endpoints were overall survival (OS) and treatment-related adverse events (TRAEs). A Bayesian framework was applied to facilitate indirect comparisons, of which the outcomes were presented using cumulative ranking curve (SUCRA) values, synthesized hazard ratio, risk ratio, and 95% credible interval. A total of 3140 patients were identified. Pooled results of PFS revealed that chemotherapy plus AKT inhibitors (AKTi) was likely the most effective therapy among enrolled therapies (SUCRA = 91.6%), of which the result remained consistent in comparative analysis for OS. In addition, no significant difference was detected between PD-1/PD-L1 antibodies in patients, whereas the PD-1 inhibitors (PD-1i) regimen was advantageous over PD-L1 inhibitor (PD-L1i) therapy for PD-L1 positive TNBC. Concerning TRAEs, an apparent heterogeneity associated with safety profiles were denoted among enrolled agents. Chemotherapy plus AKTi was the most effective therapy with comparable safety profiles. Chemotherapy plus the anti-PD-1 regimen was advantageous over the combination therapy based on the PD-L1 blockade.
Insights
Chemotherapy plus AKT inhibitors (AKTi) shows promise as a first-line treatment for triple-negative breast cancer (TNBC), improving progression-free survival. PD-1 inhibitors also offer benefits for PD-L1 positive TNBC patients.
Area of Science:
- Oncology
- Clinical Pharmacology
- Biostatistics
Background:
- Triple-negative breast cancer (TNBC) lacks targeted therapies, necessitating research into optimal first-line treatments.
- Identifying effective first-line therapies is crucial for improving outcomes in TNBC patients.
Purpose of the Study:
- To determine the most advantageous first-line therapy for patients with triple-negative breast cancer (TNBC).
Main Methods:
- A systematic review and Bayesian network meta-analysis of randomized controlled trials (RCTs) published between January 2001 and December 2021.
- Searched databases included Medline, Embase, ClinicalTrials.gov, and the Cochrane Library.
- Primary endpoint: progression-free survival (PFS); Secondary endpoints: overall survival (OS) and treatment-related adverse events (TRAEs).
Main Results:
- Chemotherapy plus AKT inhibitors (AKTi) emerged as the most effective therapy for PFS (SUCRA=91.6%) and OS.
- No significant difference was observed between PD-1 and PD-L1 antibodies overall.
- PD-1 inhibitors (PD-1i) showed an advantage over PD-L1 inhibitors (PD-L1i) in PD-L1 positive TNBC.
- Heterogeneity in treatment-related adverse events (TRAEs) was noted across therapies.
- Chemotherapy plus AKTi demonstrated comparable safety profiles.
Conclusions:
- Chemotherapy combined with AKT inhibitors represents a highly effective first-line treatment option for TNBC, with favorable safety.
- Anti-PD-1 regimens are advantageous over PD-L1 blockade combinations for PD-L1 positive TNBC.
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