PMID- 37787817 OWN - NLM STAT- MEDLINE DCOM- 20240108 LR - 20240216 IS - 1573-7217 (Electronic) IS - 0167-6806 (Linking) VI - 203 IP - 1 DP - 2024 Jan TI - Comparative efficacy and safety of extended adjuvant endocrine therapy for hormone receptor-positive early breast cancer: a Bayesian network meta-analysis. PG - 13-28 LID - 10.1007/s10549-023-07105-9 [doi] AB - PURPOSE: Optimal extended adjuvant endocrine therapy (ET) duration and strategy for hormone receptor-positive (HR +) early breast cancer remain unclear. In this network meta-analysis (NMA), the efficacy and safety of all available extended adjuvant ETs were compared and ranked. METHODS: PubMed, Embase, and Cochrane Library and abstracts presented at ASCO, SABCS, and ESMO were searched on March 5, 2022. Fourteen randomized controlled trials (RCTs) comprising eight extended adjuvant ETs for HR + breast cancer and 38,070 patients were analyzed. Main outcomes were disease-free survival (DFS), overall survival (OS), grade >/= 3 adverse events (AEs), and contralateral breast cancer (CBC). Direct and indirect comparisons were integrated via Bayesian NMA. Hierarchical cluster analysis was performed to jointly rank efficacy and safety outcomes. RESULTS: Compared with that of 5 year ET, extended 10 year aromatase inhibitor (AI) treatment provided the greatest DFS benefit (HR = 0.45, 95%CrI 0.23-0.83), whereas no strategy differed significantly in terms of the other main outcomes. Extended 10 year AI treatment was the preferred strategy for DFS improvement and CBC prevention (surface under the cumulative ranking curve: 93.51% and 91.29% probability, respectively). All strategies had comparable safeties (grade >/= 3 AEs). Compared with that of 5 year ET, 10 year extended AI significantly increased arthralgia (OR = 1.65, 95%CrI 1.02-2.93) and osteoporosis (OR = 3.33, 95%CrI 1.19-9.68). CONCLUSION: Extended 10 year AI therapy may be optimal for HR + early breast cancer given its relatively high efficacy and safety. CI - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - He, Peng AU - He P AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. FAU - Li, Jing AU - Li J AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. FAU - Chen, Minyan AU - Chen M AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. FAU - Huang, Meng AU - Huang M AD - Fujian Center for Disease Control and Prevention, Fuzhou, Fujian, China. FAU - Qiu, Yibin AU - Qiu Y AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. FAU - Cai, Qindong AU - Cai Q AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. FAU - Lin, Yuxiang AU - Lin Y AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. lyx0520@fjmu.edu.cn. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. lyx0520@fjmu.edu.cn. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. lyx0520@fjmu.edu.cn. FAU - Wang, Chuan AU - Wang C AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. dr_chuanwang@fjmu.edu.cn. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. dr_chuanwang@fjmu.edu.cn. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. dr_chuanwang@fjmu.edu.cn. FAU - Fu, Fangmeng AU - Fu F AUID- ORCID: 0000-0002-3065-5708 AD - Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China. ffm@fjmu.edu.cn. AD - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China. ffm@fjmu.edu.cn. AD - Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China. ffm@fjmu.edu.cn. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review DEP - 20231003 PL - Netherlands TA - Breast Cancer Res Treat JT - Breast cancer research and treatment JID - 8111104 RN - 0 (Aromatase Inhibitors) SB - IM MH - Humans MH - Female MH - *Breast Neoplasms MH - Network Meta-Analysis MH - Chemotherapy, Adjuvant MH - Aromatase Inhibitors/adverse effects MH - Disease-Free Survival MH - Randomized Controlled Trials as Topic OTO - NOTNLM OT - Aromatase inhibitor OT - Breast cancer OT - Extended adjuvant endocrine therapy OT - Hormone receptor-positive OT - Network meta-analysis OT - Tamoxifen EDAT- 2023/10/03 12:44 MHDA- 2024/01/08 06:42 CRDT- 2023/10/03 11:05 PHST- 2023/03/22 00:00 [received] PHST- 2023/08/23 00:00 [accepted] PHST- 2024/01/08 06:42 [medline] PHST- 2023/10/03 12:44 [pubmed] PHST- 2023/10/03 11:05 [entrez] AID - 10.1007/s10549-023-07105-9 [pii] AID - 10.1007/s10549-023-07105-9 [doi] PST - ppublish SO - Breast Cancer Res Treat. 2024 Jan;203(1):13-28. doi: 10.1007/s10549-023-07105-9. Epub 2023 Oct 3.