To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation thera...To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.展开更多
Background:The current standard of care for advanced human epidermal growth factor receptor 2(HER2)‐positive breast cancer is pertuzumab plus trastuzumab and docetaxel as first‐line therapy.However,with the developm...Background:The current standard of care for advanced human epidermal growth factor receptor 2(HER2)‐positive breast cancer is pertuzumab plus trastuzumab and docetaxel as first‐line therapy.However,with the development of newer treatment regimens,there is a lack of evidence regarding which is the optimal treatment strategy.The aim of this network meta‐analysis was to evaluate the efficacy and safety of first‐line regimens for advanced HER2‐positive breast cancer by indirect comparisons.Methods:A systematic review and Bayesian network meta‐analysis were conducted.The PubMed,EMBASE,and Cochrane Library databases were searched for relevant articles published through to December 2023.The hazard ratio(HR)and 95%credible interval(CrI)were used to compare progressionfree survival(PFS)between treatments,and the odds ratio and 95%CrI were used to compare the objective response rate(ORR)and safety.Results:Twenty randomized clinical trials that included 15 regimens and 7094 patients were analyzed.Compared with the traditional trastuzumab and docetaxel regimen,PFS was longer on the pyrotinib and trastuzumab plus docetaxel regimen(HR:0.41,95%CrI:0.22–0.75)and the pertuzumab and trastuzumab plus docetaxel regimen(HR:0.65,95%CrI:0.43–0.98).Consistent with the results for PFS,the ORR was better on the pyrotinib and trastuzumab plus docetaxel regimen and the pertuzumab and trastuzumab plus docetaxel regimen than on the traditional trastuzumab and docetaxel regimen.The surface under the cumulative ranking curve indicated that the pyrotinib and trastuzumab plus docetaxel regimen was most likely to rank first in achieving the best PFS and ORR.Comparable results were found for grade≥3 AE rates of≥10%.Conclusions:Our results suggest that the pyrotinib and trastuzumab plus docetaxel regimen is most likely to be the optimal first‐line therapy for patients with HER2‐positive breast cancer.展开更多
基金funded by grants from the Shanghai Science Committee Foundation(No.19411967700)the National Natural Science Foundation of China(No.31570993)the Wu Jieping Medical Foundation(No.320.6750.2020-14-7).
文摘To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.
基金National Key Research and Development Program of China,Grant/Award Number:2021YFF1201300National Natural Science Foundation of China,Grant/Award Number:82230058。
文摘Background:The current standard of care for advanced human epidermal growth factor receptor 2(HER2)‐positive breast cancer is pertuzumab plus trastuzumab and docetaxel as first‐line therapy.However,with the development of newer treatment regimens,there is a lack of evidence regarding which is the optimal treatment strategy.The aim of this network meta‐analysis was to evaluate the efficacy and safety of first‐line regimens for advanced HER2‐positive breast cancer by indirect comparisons.Methods:A systematic review and Bayesian network meta‐analysis were conducted.The PubMed,EMBASE,and Cochrane Library databases were searched for relevant articles published through to December 2023.The hazard ratio(HR)and 95%credible interval(CrI)were used to compare progressionfree survival(PFS)between treatments,and the odds ratio and 95%CrI were used to compare the objective response rate(ORR)and safety.Results:Twenty randomized clinical trials that included 15 regimens and 7094 patients were analyzed.Compared with the traditional trastuzumab and docetaxel regimen,PFS was longer on the pyrotinib and trastuzumab plus docetaxel regimen(HR:0.41,95%CrI:0.22–0.75)and the pertuzumab and trastuzumab plus docetaxel regimen(HR:0.65,95%CrI:0.43–0.98).Consistent with the results for PFS,the ORR was better on the pyrotinib and trastuzumab plus docetaxel regimen and the pertuzumab and trastuzumab plus docetaxel regimen than on the traditional trastuzumab and docetaxel regimen.The surface under the cumulative ranking curve indicated that the pyrotinib and trastuzumab plus docetaxel regimen was most likely to rank first in achieving the best PFS and ORR.Comparable results were found for grade≥3 AE rates of≥10%.Conclusions:Our results suggest that the pyrotinib and trastuzumab plus docetaxel regimen is most likely to be the optimal first‐line therapy for patients with HER2‐positive breast cancer.
