PMID- 32008124
OWN - NLM
STAT- MEDLINE
DCOM- 20201123
LR  - 20201123
IS  - 1573-7217 (Electronic)
IS  - 0167-6806 (Linking)
VI  - 180
IP  - 2
DP  - 2020 Apr
TI  - Anastrozole plus fulvestrant vs. anastrozole alone for hormone receptor-positive 
      advanced breast cancer: a meta-analysis of randomized controlled trials.
PG  - 269-278
LID - 10.1007/s10549-020-05551-3 [doi]
AB  - BACKGROUND: For patients with hormone receptor (HR)-positive advanced breast 
      cancer, whether the combination of anastrozole and fulvestrant is more effective 
      than anastrozole alone is controversial. Our meta-analysis aimed to compare the 
      efficacy and safety of the two therapies. METHODS: We retrieved relevant studies 
      in Embase, the Cochrane Library, Ovid MEDLINE, PubMed, ScienceDirect, Web of 
      Science, Scopus, and Google Scholar. The primary outcomes were overall survival 
      (OS) and progression-free survival (PFS). The secondary outcomes were the disease 
      control rate (DCR), the objective response rate (ORR), and adverse events (AEs). 
      RESULTS: Five articles based on 4 randomized controlled trials containing 2146 
      patients were identified in our meta-analysis. The combination group had better 
      efficacy in the endpoints of OS (hazard ratio [HR] 0.86; 95% confidence interval 
      [CI] 0.74-0.99, p = 0.03) and PFS (HR 0.87; 95% CI 0.77-0.97, p = 0.02). 
      Regarding the ORR, DCR, total AEs and grade 3-5 AEs, we found no difference 
      between the two treatments. The combination group showed a clearly higher rate of 
      treatment discontinuations (95% CI 1.05-3.60, p = 0.03) and AEs leading to death 
      (95% CI 1.12-9.11, p = 0.03). The subgroup analysis of AEs showed an increased 
      incidence of extremity or muscle pain, hematologic effects, gastrointestinal 
      disorders, and hot flashes in the combination group. CONCLUSIONS: For HR-positive 
      advanced breast cancer patients, the combination of anastrozole and fulvestrant 
      appears to be superior to anastrozole alone in extending PFS and OS, despite 
      relatively serious AEs.
FAU - Li, Meng
AU  - Li M
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Road, Nanchang, 330006, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
FAU - Xiong, Yiting
AU  - Xiong Y
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Road, Nanchang, 330006, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
FAU - Liao, Chen
AU  - Liao C
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
AD  - Department of Breast Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, 330006, China.
FAU - He, Yunyan
AU  - He Y
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
AD  - Department of Breast Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, 330006, China.
FAU - Duan, Sijia
AU  - Duan S
AD  - Department of Breast Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, 330006, China.
FAU - Yi, Fengming
AU  - Yi F
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, 330006, China.
FAU - Wei, Yiping
AU  - Wei Y
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Road, Nanchang, 330006, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AUID- ORCID: 0000-0003-2962-0847
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Road, Nanchang, 330006, China. zwx123dr@126.com.
LA  - eng
GR  - 81560345/National Natural Science Foundation of China/
GR  - 20161BAB215237/Natural Science Foundation of Jiangxi Province/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20200201
PL  - Netherlands
TA  - Breast Cancer Res Treat
JT  - Breast cancer research and treatment
JID - 8111104
RN  - 22X328QOC4 (Fulvestrant)
RN  - 2Z07MYW1AZ (Anastrozole)
SB  - IM
MH  - Anastrozole/administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Breast Neoplasms/*drug therapy/pathology
MH  - Female
MH  - Fulvestrant/administration & dosage
MH  - Humans
MH  - Prognosis
MH  - *Randomized Controlled Trials as Topic
MH  - Survival Rate
OTO - NOTNLM
OT  - Anastrozole
OT  - Breast cancer
OT  - Fulvestrant
OT  - Hormone receptor positive
OT  - Meta-analysis
EDAT- 2020/02/03 06:00
MHDA- 2020/11/24 06:00
CRDT- 2020/02/03 06:00
PHST- 2019/09/24 00:00 [received]
PHST- 2020/01/27 00:00 [accepted]
PHST- 2020/02/03 06:00 [pubmed]
PHST- 2020/11/24 06:00 [medline]
PHST- 2020/02/03 06:00 [entrez]
AID - 10.1007/s10549-020-05551-3 [pii]
AID - 10.1007/s10549-020-05551-3 [doi]
PST - ppublish
SO  - Breast Cancer Res Treat. 2020 Apr;180(2):269-278. doi: 
      10.1007/s10549-020-05551-3. Epub 2020 Feb 1.