Evidence map›Paper›PMID 37653504›Full record

ArticleBMC cancer2023

Comparative efficacy and safety of different combinations of three CDK4/6 inhibitors with endocrine therapies in HR+/HER-2 - metastatic or advanced breast cancer patients: a network meta-analysis.

Yiyuan Liu, Jinyao Wu, Zeqi Ji, Lingzhi Chen, Juan Zou, Jiehua Zheng, Weixun Lin, Jiehui Cai, Yaokun Chen, Daitian Zheng and 2 more

Open access · goldAbstract readNetwork Meta-Analysis
In one paragraph

Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
7.2field-weighted citation impact, top 2% 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

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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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

12 authors at 2 institutions in 1 country.

Yiyuan Liu *Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Jinyao Wu *Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Zeqi Ji *Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Lingzhi ChenDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Juan ZouDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Jiehua ZhengDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Weixun LinDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Jiehui CaiDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Yaokun ChenDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Daitian ZhengDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China.
Yexi ChenDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China. yxchen3@stu.edu.cn.
Zhiyang LiDepartment of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, Guangdong, China. s_zyli4@stu.edu.cn.
Second Affiliated Hospital of Shantou University Medical College · CNShantou University · CN

Funding

Medical Scientific Research Foundation of Guangdong Province, China A2021432, B2021448Shantou Medical Science and Technology Planning Project 210521236491457, 210625106490696the Special Fund Project of Guangdong Science and Technology 210728156901524, 210728156901519the Undergraduate Innovation Training Project of Shantou University 31/38/47/54
6 · The paper itself

Abstract

backgroundThis network meta-analysis aimed to assess the comparative efficacy and safety of combinations involving three cyclin-dependent kinase 4/6 (CDK4/6) inhibitors and endocrine therapies (ETs) in patients with metastatic or advanced breast cancer (BC) who are hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-).

methodsWe initially identified relevant studies from previous meta-analyses and then conducted a comprehensive search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases to locate additional studies published between February 2020 and September 2021. Essential data were extracted, and a network meta-analysis was performed using R 4.1.1 software with a random-effects model. Furthermore, we assigned rankings to all available treatment combinations by calculating their cumulative probability.

resultsData analysis included ten reports from nine studies. Pooled results demonstrated that each treatment combination significantly reduced the hazard risk of progression-free survival (PFS) compared to treatment with an aromatase inhibitor (AI) or fulvestrant alone. However, there were no differences observed in PFS or overall survival (OS) among the different treatment combinations. Additionally, patients receiving palbociclib plus AI and abemaciclib plus AI or fulvestrant experienced more severe adverse events (AEs), with hazard ratios (HRs) of 10.83 (95% confidence interval [CI] = 2.3 to 52.51) and 4.8 (95%CI = 1.41 to 16.21), respectively. The HR for ribociclib plus AI was 9.45 (95%CI = 2.02 to 43.61), and the HR for palbociclib plus fulvestrant was 6.33 (95%CI = 1.03 to 39.86). Based on the ranking probabilities, palbociclib plus fulvestrant had the highest probability of achieving superior PFS (37.65%), followed by abemaciclib plus fulvestrant (28.76%). For OS, ribociclib plus fulvestrant ranked first (34.11%), with abemaciclib plus fulvestrant in second place (25.75%). In terms of safety, palbociclib plus AI (53.98%) or fulvestrant (51.37%) had the highest probabilities of being associated with adverse events.

conclusionsAbemaciclib plus fulvestrant or ribociclib plus AI appear to be effective and relatively safe for the treatment of HR+/HER2- metastatic or advanced BC patients. However, given the reliance on limited evidence, our findings require further validation through additional studies.

Indexed as

Breast NeoplasmsAminopyridinesAromatase InhibitorsBenzimidazolesCyclin-Dependent Kinase 4Erb-b2 Receptor Tyrosine KinasesFemaleFulvestrantHumansPurinesabemaciclibAminopyridinesAromatase InhibitorsBenzimidazolesCDK4 protein, humanCyclin-Dependent Kinase 4ERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesFulvestrantPurinesribociclibAbemaciclibBreast cancerNetwork meta-analysisPalbociclibRibociclib

Identifiers

PMID37653504
PMCPMC10469949
OpenAlexW4386328992

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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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.