PMID- 34801695
OWN - NLM
STAT- MEDLINE
DCOM- 20211209
LR  - 20211214
IS  - 1879-0461 (Electronic)
IS  - 1040-8428 (Linking)
VI  - 168
DP  - 2021 Dec
TI  - Addition of immunotherapy to chemotherapy for metastatic triple-negative breast 
      cancer: A systematic review and meta-analysis of randomized clinical trials.
PG  - 103530
LID - S1040-8428(21)00317-6 [pii]
LID - 10.1016/j.critrevonc.2021.103530 [doi]
AB  - BACKGROUND: One of the front treatment regimens used for metastatic 
      triple-negative breast cancer (mTNBC) is treatment with programmed death-1 (PD-1) 
      or programmed death ligand-1 (PD-L1) blockade combine with chemotherapy. However, 
      the results of such studies have been controversial. METHODS: A systematic 
      searched of PubMed, Embase, Cochrane Library, and the proceedings of the last 5 
      years of several meetings until February 18, 2021. The primary endpoint was the 
      progression-free survival (PFS) of PD-L1-positive patients treated with PD1/PD-L1 
      blockade plus chemotherapy compare with chemotherapy. RESULTS: Overall, 4 studies 
      that included a total of 3007 mTNBC patients were analyzed in this meta-analysis. 
      PFS was significantly improved in the PD1/PD-L1 blockade plus chemotherapy group 
      compared with the chemotherapy group in PD-L1-positive mTNBC patients (hazard 
      ratios, (HR), 0.69; 95% CI, 0.59-0.80; P < .001), also in intention-to-treat 
      (ITT) population (HR, 0.82; 95% CI, 0.74-0.90; P < .001). However, no significant 
      benefit in overall survival (OS) was observed regardless of PD-L1 status or ITT 
      population. The immunotherapy plus chemotherapy has higher adverse events (AEs) 
      compared with chemotherapy (all AEs, Odds ratios (ORs), 2.33; 95% CI, 1.50-3.62; 
      P < .001; grade 3-5 AEs, OR, 1.27; 95% CI, 1.04-1.55; P = .019). CONCLUSIONS: 
      This meta-analysis showed that the addition of PD1/PD-L1 blockade to chemotherapy 
      improved PFS in PD-L1 positive mTNBC patients, also in the ITT population. 
      However, no significant benefit in OS was observed in patients of PD-L1 positive 
      or in the ITT population after adding PD1/PD-L1 blockade. We found a higher rate 
      of AEs with the addition of PD1/PD-L1 blockers to chemotherapy.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Huo, Xingfa
AU  - Huo X
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: xingfahuo@126.com.
FAU - Shen, Guoshuang
AU  - Shen G
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: guoshuangshen@126.com.
FAU - Liu, Zhen
AU  - Liu Z
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: qhdxlz@163.com.
FAU - Liang, Yuhua
AU  - Liang Y
AD  - Graduate School of Qinghai University & Qinghai Provincial People's Hospital, 
      Xining 810000, China. Electronic address: lyh970128@126.com.
FAU - Li, Jinming
AU  - Li J
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: jinmingli0212@163.com.
FAU - Zhao, Fuxing
AU  - Zhao F
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: 18797349621@163.com.
FAU - Ren, Dengfeng
AU  - Ren D
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: dengfeng1104@126.com.
FAU - Zhao, Jiuda
AU  - Zhao J
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, 
      China. Electronic address: jiudazhao@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20211118
PL  - Netherlands
TA  - Crit Rev Oncol Hematol
JT  - Critical reviews in oncology/hematology
JID - 8916049
RN  - 0 (B7-H1 Antigen)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - B7-H1 Antigen
MH  - Humans
MH  - Immunotherapy
MH  - Progression-Free Survival
MH  - Randomized Controlled Trials as Topic
MH  - *Triple Negative Breast Neoplasms/drug therapy
OTO - NOTNLM
OT  - Atezolizumab
OT  - Durvalumab
OT  - Immune-checkpoint inhibitor
OT  - Immunotherapy
OT  - Metastatic triple-negative breast cancer
OT  - Pembrolizumab
OT  - Survival
EDAT- 2021/11/22 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/11/21 20:42
PHST- 2021/05/16 00:00 [received]
PHST- 2021/11/05 00:00 [revised]
PHST- 2021/11/15 00:00 [accepted]
PHST- 2021/11/22 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/11/21 20:42 [entrez]
AID - S1040-8428(21)00317-6 [pii]
AID - 10.1016/j.critrevonc.2021.103530 [doi]
PST - ppublish
SO  - Crit Rev Oncol Hematol. 2021 Dec;168:103530. doi: 
      10.1016/j.critrevonc.2021.103530. Epub 2021 Nov 18.