Network meta-analysis of targeted drugs in combination with chemotherapy for advanced/metastatic triple-negative breast cancer treatment

Purpose: This study investigates the therapeutic efficacy of various targeted drugs in combination with chemotherapy on ad-vanced/metastatic triple-negative breast cancer (TNBC) by a network meta-analysis. Methods: Literatures from PubMed, Web of Science, Embase, and CNKI databases were searched to retrieve the relevant published data, and many randomized controlled trials (RCTs) on TNBC were selected according to the inclusion and exclusion criteria. The progression-free survival (PFS), overall survival (OS), the adverse effect rate (AEs), and treatment response rate (RR) of TNBC patients for all retrieved literatures were extracted. R software and Hasse diagrams was used to analyze the therapeutic effects of different targeted drugs combined with chemotherapy. Results: A total of 16 RCTs were included in the study. The PFS (Hazard ratio (HR) 0.72, 95% CI 0.66-0.79, p < 0.001) and OS (HR 0.92, 95%CI 0.84-1.0, p = 0.0475) were calculated among the studies. By comparing with combined regimens, we found that Iniparib combined with chemotherapy has a better therapeutic effect on prolonging PFS (HR p-Score = 0.55, AEs p–Score = 0.80, RR p-Score = 0.82). Conclusion: Based on the network meta-analysis of combined regimens for TNBC patients with PFS, OS, AEs and RR for screening the optimal treatment regimen, we propose that the PFS of patients with TNBC could be improved by a combination chemotherapy including iniparib, cetuximab, taxane or ipatasertib.

Triple negative breast cancer; Targeted drugs; Network analysis; Progression-free survival; Overall survival.

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