ObjectiveTo systematically review the prognostic value of circulating tumour cells (CTCs) in non-metastatic breast cancer patients. MethodsWe electronically searched PubMed, EMbase, WanFang Data, CNKI and CBM for collecting cohort studies about the prognostic relevance of CTCs in the peripheral blood of stage I to Ⅲ breast cancer patients from inception to March 20th, 2014. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 7 studies involving 1 780 patients were eligible for final analyses. The results of meta-analysis showed that, the presence of CTCs was associated with both poor DFS (RR=2.24, 95%CI 1.92 to 2.61, P < 0.000 01) and OS (RR=2.55, 95%CI 1.99 to 3.28, P < 0.000 01). The results of subgroup analysis by detection time of CTCs showed that CTCs detected before and after adjuvant chemotherapy was a statistically significant prognostic factor (P≤0.000 4). ConclusionCTCs is an adverse prognostic factor in non-metastatic breast cancer patients, which is not significantly influenced by adjuvant chemotherapy.
Objective To summarize the research progress of immunotherapy for metastatic breast cancer. Method Literatures about immunotherapy for metastatic breast cancer were reviewed by searching the literatures in domestic and foreign database. Results In recent years, immunotherapy had been initially attempted in patients with metastatic breast cancer and showed its unique value. It provided a new way to improve the therapeutic effect and prolong the survival time of patients with metastatic breast cancer. ConclusionsImmunotherapy is the most effective in triple-negative metastatic breast cancers. The immuno-oncology needs to be developed to improve the clinical benefits of immunotherapy for breast cancer.
Objective To compare the efficacy and safety of different cyclin-dependent kinase4/6 inhibitor (CDK4/6i) combined with endocrine therapy (ET) for HR+/HER2- advanced or metastatic breast cancer based on mesh meta-analysis. Methods Randomized controlled trials (RCTs) of CDK4/6i in the treatment of HR+/HER2- metastatic/advanced breast cancer were searched in PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed databases from inception to August 2023. Bayesian network meta-analysis was performed by R 4.2.0 software. Results Finally, 18 RCTs in 25 articles, covering 8 031 patients, involving 11 treatment regimens were included. There were no statistical differences in progression-free survival (PFS) or overall survival (OS) between CDK4/6i+ET combinations. DAL+FUL ranked first in PFS rate, and RIB+FUL ranked first in OS rate. In terms of effectiveness, ABE+AI and ABE+FUL ranked first in objective response rate (ORR) and clinical benefit rate (CBR), respectively. In terms of safety, there were significant differences in grade 3-4 AEs and SAE among some CDK4/6i types (P<0.05). Conclusion Current evidence shows that CDK4/6i+ET is superior to ET alone in the treatment of HR+/HER2- advanced/metastatic breast cancer, and different combinations of CDK4/6i+ET have the same or similar effects, but the combination has a higher incidence of adverse reactions, and a reasonable treatment plan should be selected according to the individual situation of patients.