Evidence map›Paper›PMID 32404154›Full record

SynthesisBMC cancer2020

Combined endocrine approaches vs endocrine therapy alone as first line treatment in elderly patients with hormone receptor-positive, HER2 negative, advanced breast cancer: to prescribe for the patient or the physician? A meta-analysis of phase II and III randomized clinical trials.

Claudia Omarini, Federico Piacentini, Isabella Sperduti, Monica Barbolini, Chrystel Isca, Angela Toss, Laura Cortesi, Elena Barbieri, Massimo Dominici, Luca Moscetti

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in BMC cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Claudia OmariniDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy. claudia.omarini@gmail.com.ORCID http://orcid.org/0000-0002-2906-7896
Federico PiacentiniDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Isabella SperdutiDepartment of Bio-Statistics, RCCS Regina Elena National Cancer Institute, 00144, Rome, Italy.
Monica BarboliniDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Chrystel IscaDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Angela TossDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Laura CortesiDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Elena BarbieriDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Massimo DominiciDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
Luca MoscettiDivision of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71 -, 41122, Modena, Italy.
University of Modena and Reggio Emilia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElderly patients are underrepresented in clinical study where combined endocrine strategies were compared to endocrine therapy (ET) in hormone receptors positive, HER2 negative, metastatic breast cancer. The role of the new endocrine approaches in elderly women is still unclear.

methodsWe performed a meta-analysis of first line phase II/III randomized trials on ET versus combined strategies considering clinical benefit and safety profile. Trials with hazard ratio (HR) for PFS in elderly patients were included.

resultsOverall, the meta-analysis showed a PFS advantage for the experimental arms [HR 0.77, p 0.016] with a significant high/moderate heterogeneity [I2 65.46%, p 0.005]. For patients on CDK 4/6 inhibitors and ET, HR was 0.57 (p < 0.0001), with low heterogeneity [I2 0.0001%, p 0.96]. Hematological adverse events, as well as diarrhea with Abemaciclib, were significantly higher in elderly population.

conclusionsThe magnitude of PFS benefit due to the combined strategies in elderly patients is similar to those reported in the overall clinical trial population. Adding CDK4/6 inhibitors to ET significantly prolongs PFS, even if toxicity profile have to be carefully considered. Future trials should be designed taking into account patients' age, geriatric assessment and comorbidity.

Indexed as

Antineoplastic Agents, HormonalBreast NeoplasmsClinical Trials, Phase II as TopicClinical Trials, Phase III as TopicErb-b2 Receptor Tyrosine KinasesFemaleHumansPractice Patterns, Physicians'Protein Kinase InhibitorsRandomized Controlled Trials as TopicReceptors, EstrogenReceptors, ProgesteroneAntineoplastic Agents, HormonalERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesProtein Kinase InhibitorsReceptors, EstrogenReceptors, ProgesteroneAbemaciclibCD4/6 inhibitorsEndocrine therapyMetastatic breast cancerPalbociclibRibociclib

Identifiers

PMID32404154
PMCPMC7222291
OpenAlexW3027235130

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.