PMID- 28296916
OWN - NLM
STAT- MEDLINE
DCOM- 20170907
LR  - 20220311
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 3
DP  - 2017
TI  - The efficacy and toxicity profile of metronomic chemotherapy for metastatic 
      breast cancer: A meta-analysis.
PG  - e0173693
LID - 10.1371/journal.pone.0173693 [doi]
LID - e0173693
AB  - PURPOSE: The current meta-analysis aimed to summarize the available evidence for 
      the efficacy and serious adverse events (AEs) associated with use of metronomic 
      chemotherapy (MCT) in patients with metastatic breast cancer (MBC). METHOD: 
      Electronic databases (PubMed, EMBASE database, Web of Knowledge, and the Cochrane 
      database) were systematically searched for articles related to the use of MCT in 
      MBC patients. Eligible studies included clinical trials of MBC patients treated 
      with MCT that presented sufficient data related to tumor response, 
      progression-free survival (PFS), overall survival (OS), and grade 3/4 AEs. A 
      meta-analysis was performed using a random effects model. RESULTS: This 
      meta-analysis consists of 22 clinical trials with 1360 patients. The pooled 
      objective response rate and clinical benefit rate of MCT were 34.1% (95% CI 
      27.4-41.5) and 55.6% (95% CI 49.2-61.9), respectively. The overall 6-month PFS, 
      12-month OS, and 24-month OS rates were 56.8% (95% CI 48.3-64.9), 70.3% (95% CI 
      62.6-76.9), and 40.0% (95% CI 30.6-50.2), respectively. The pooled incidence of 
      grade 3/4 AEs was 29.5% (95% CI 21.1-39.5). There was no statistically 
      significant difference observed in any endpoint between subgroups defined by 
      concomitant anti-cancer therapies or chemotherapy regimens. After excluding one 
      controversial study, we observed a trend showing lower toxicity rates with the 
      use of MCT alone compared to use of MCT with other anti-cancer therapies (P = 
      0.070). CONCLUSIONS: Metronomic chemotherapy may be effective for use in patients 
      with metastatic breast cancer. MCT used alone is possibly equally effective and 
      less toxic than combination therapies. Well-designed RCTs are needed to obtain 
      more evidence.
FAU - Liu, Yangyang
AU  - Liu Y
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Gu, Feifei
AU  - Gu F
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Liang, Jinyan
AU  - Liang J
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Dai, Xiaomeng
AU  - Dai X
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Wan, Chao
AU  - Wan C
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Hong, Xiaohua
AU  - Hong X
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Zhang, Kai
AU  - Zhang K
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
FAU - Liu, Li
AU  - Liu L
AD  - Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of 
      Science and Technology, Wuhan, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20170315
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Breast Neoplasms/*drug therapy/pathology
MH  - Humans
MH  - Neoplasm Metastasis
MH  - Survival Rate
PMC - PMC5351982
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/03/16 06:00
MHDA- 2017/09/08 06:00
PMCR- 2017/03/15
CRDT- 2017/03/16 06:00
PHST- 2016/08/26 00:00 [received]
PHST- 2017/02/26 00:00 [accepted]
PHST- 2017/03/16 06:00 [entrez]
PHST- 2017/03/16 06:00 [pubmed]
PHST- 2017/09/08 06:00 [medline]
PHST- 2017/03/15 00:00 [pmc-release]
AID - PONE-D-16-34300 [pii]
AID - 10.1371/journal.pone.0173693 [doi]
PST - epublish
SO  - PLoS One. 2017 Mar 15;12(3):e0173693. doi: 10.1371/journal.pone.0173693. 
      eCollection 2017.