To the Editor:Breast cancer(BC)is the most common malignancy in women.Statistics show that 1.2 million women worldwide have BC each year,and 500,000 women die from BC.It is the leading cause of death in women.[1]Accor...To the Editor:Breast cancer(BC)is the most common malignancy in women.Statistics show that 1.2 million women worldwide have BC each year,and 500,000 women die from BC.It is the leading cause of death in women.[1]According to the different expressions of estrogen receptor(ER),progesterone receptor(PR),and epidermal growth factor receptor 2(HER2),three receptor markers,BC is divided into four subtypes in clinical diagnosis.[2]MicroRNAs(miRNAs)have a wide range of regulatory effects and can regulate a variety of normal or pathogenic cell processes.展开更多
Background:As the efficacy of programmed cell death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors combined with chemotherapy in curing breast cancer is still controversial,this meta-analysis compares the efficacy ...Background:As the efficacy of programmed cell death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors combined with chemotherapy in curing breast cancer is still controversial,this meta-analysis compares the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy and chemotherapy alone in the treatment of breast cancer,which provides guidance for the clinical treatment.Methods:Relevant studies published as of April 2022 in the various databases including EMBASE,PubMed,and Cochrane Library were selected.Randomized controlled trials(RCTs)in which control patients underwent chemotherapy alone and experimental group patients underwent combination chemotherapy and PD-1/PD-L1 inhibitor treatment were included in this investigation.Investigations without complete information,researches from which information could not be extracted,duplicate articles,animal studies,review articles,and systematic reviews were excluded.STATA 15.1 was employed for all statistical analyses.Results:In total,eight eligible studies were identified,revealing that combination chemotherapy and PD-1/PD-L1 inhibitor treatment was linked to significant increases in progression-free survival(PFS)relative to chemotherapy alone(hazard ratio[HR]=0.83,95%confidence interval[CI]:0.70–0.99,P=0.032)but not overall survival(HR=0.92,95%CI:0.80–1.06,P=0.273).Pooled adverse event rates were also increased within the group of combination treatment relative to the chemotherapy group(risk ratio[RR]=1.08,95%CI:1.03–1.14,P=0.002).Specifically,nausea rates were lesser within the group of combination treatment relative to the group of chemotherapy(RR=0.48,95%CI:0.25–0.92,P=0.026).Subgroup analyses indicated that the PFS of patients who underwent combination atezolizumab or pembrolizumab and chemotherapy treatment were substantially longer than those of patients who underwent chemotherapy alone(HR=0.79,95%CI:0.69–0.89,P≤0.001;HR=0.79,95%CI:0.67–0.92,P=0.002).Conclusions:The pooled results suggest that combination chemotherapy and PD-1/PD-L1 inhibitor treatment approaches help prolong PFS in breast cancer patients,but have no statistically significant effect on overall survival(OS).Additionally,combination therapy can significantly improve complete response rate(CRR)compared with chemotherapy alone.However,combination therapy was associated with greater rates of adverse events.展开更多
基金supported by grants from the Natural Science Foundation of China(No.82102814)Zhejiang Provincial Natural Science Foundation of China under grants(No.LQ22H160053)+1 种基金Zhejiang Provincial People’s Hospital Scientific Research Foundation for The Excellent Youth(No.ZRY2020B007)Suzhou Youth Science and Technology Program(No.KJXW2021067)
文摘To the Editor:Breast cancer(BC)is the most common malignancy in women.Statistics show that 1.2 million women worldwide have BC each year,and 500,000 women die from BC.It is the leading cause of death in women.[1]According to the different expressions of estrogen receptor(ER),progesterone receptor(PR),and epidermal growth factor receptor 2(HER2),three receptor markers,BC is divided into four subtypes in clinical diagnosis.[2]MicroRNAs(miRNAs)have a wide range of regulatory effects and can regulate a variety of normal or pathogenic cell processes.
基金supported by a grant from the Suzhou Youth Science and Technology Program(No.KJXW2021067).
文摘Background:As the efficacy of programmed cell death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors combined with chemotherapy in curing breast cancer is still controversial,this meta-analysis compares the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy and chemotherapy alone in the treatment of breast cancer,which provides guidance for the clinical treatment.Methods:Relevant studies published as of April 2022 in the various databases including EMBASE,PubMed,and Cochrane Library were selected.Randomized controlled trials(RCTs)in which control patients underwent chemotherapy alone and experimental group patients underwent combination chemotherapy and PD-1/PD-L1 inhibitor treatment were included in this investigation.Investigations without complete information,researches from which information could not be extracted,duplicate articles,animal studies,review articles,and systematic reviews were excluded.STATA 15.1 was employed for all statistical analyses.Results:In total,eight eligible studies were identified,revealing that combination chemotherapy and PD-1/PD-L1 inhibitor treatment was linked to significant increases in progression-free survival(PFS)relative to chemotherapy alone(hazard ratio[HR]=0.83,95%confidence interval[CI]:0.70–0.99,P=0.032)but not overall survival(HR=0.92,95%CI:0.80–1.06,P=0.273).Pooled adverse event rates were also increased within the group of combination treatment relative to the chemotherapy group(risk ratio[RR]=1.08,95%CI:1.03–1.14,P=0.002).Specifically,nausea rates were lesser within the group of combination treatment relative to the group of chemotherapy(RR=0.48,95%CI:0.25–0.92,P=0.026).Subgroup analyses indicated that the PFS of patients who underwent combination atezolizumab or pembrolizumab and chemotherapy treatment were substantially longer than those of patients who underwent chemotherapy alone(HR=0.79,95%CI:0.69–0.89,P≤0.001;HR=0.79,95%CI:0.67–0.92,P=0.002).Conclusions:The pooled results suggest that combination chemotherapy and PD-1/PD-L1 inhibitor treatment approaches help prolong PFS in breast cancer patients,but have no statistically significant effect on overall survival(OS).Additionally,combination therapy can significantly improve complete response rate(CRR)compared with chemotherapy alone.However,combination therapy was associated with greater rates of adverse events.