分子靶向治疗三阴性乳腺癌无进展生存期的网状Meta分析

Targeted Therapies for Progression Free Survival in Treating of Triple-negative Breast Cancer: a Network Meta-analysis

目的：网状Meta分析靶向药物治疗三阴性乳腺癌（TNBC）的无进展生存期（PFS）。方法：系统检索PubMed、EM-BASE．com、the Cochrane Central Register of Controlled Trials（CENTRAL）、Web of Science（via ISI Web of Knowledge）、BIOSIS Previews（via ISI Web of Knowledge）和Chemical Abstracts（CA）等数据库，追踪三阴性乳腺癌靶向治疗的系统评价或综述的参考文献，纳入靶向药物治疗三阴性乳腺癌的随机对照试验，由2名研究人员独立提取纳入研究的数据，并评价纳入研究的方法学质量，贝叶斯网状Meta分析采用WinBUGS1．4软件。结果：共纳入13个随机对照试验，包含2307例患者。纳入的研究方法学质量较高。直接比较的Meta分析结果显示：对比单纯化疗，贝伐单抗联合化疗能改善PFS（HR=0．63，95％CI：0．39—0．90）；其他靶向治疗药物联合化疗在改善PFS差异无统计学意义。间接比较的Meta分析结果显示8种干预方案之间在改善患者PFS上差异均无统计学意义。结论：靶向药物联合化疗治疗三阴性乳腺癌具有一定的疗效，然而证据的样本量不足，尚需要更多设计严谨、大样本的随机对照试验深入研究。

Objective： Our network Meta-analysis aims to determine which is the best targeted therapies for progression free survival （PFS） in treating of triple-negative breast cancer（TNBC）. Methods： 6 databases and the references of relative systematic review or Meta-analysis were searched to identify randomized controlled trials （RCTs） of containing molecularly targeted agents in the treatment of TNBC. 2 reviewers independently extracted related data and assessed the methodological quality of included studies. Bayesian network Metaanalysis was conducted using WinBUGS version 1.4 software. Results： A total of 13 RCTs met our inclusion criteria, involved 2307patients. The methodological quality of included RCTs was good. The results of direct comparisons showed that chemotherapy combination bevacizumab could significantly improve PFS when compared with chemotherapy alone. The results of indirect comparisons presented that there were no significant differences between targeted agents. Conclusion： The targeted agents combined with chemotherapy for TNBC was effective slightly. More RCTs with scientific methods were urgently needed in targeted agents for TNBC.