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Hu Q, Ye D, Xudong Z, Wang Q, Gou H, Luo T. Optimum duration of extended adjuvant endocrine therapy in patients with hormone receptor-positive breast cancer: protocol for a network meta-analysis of randomised controlled trials. BMJ Open 2023; 13:e070972. [PMID: 37080619 PMCID: PMC10124296 DOI: 10.1136/bmjopen-2022-070972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION The type of extended adjuvant endocrine therapy is not clear, nor is the optimum duration of extended adjuvant endocrine therapy for patients with early breast cancer. Our study aims to satisfy the requirements for systematically identifying and synthesising the available evidence on the clinical safety and efficacy of extended adjuvant endocrine therapy for patients with hormone receptor-positive early breast cancer. METHODS AND ANALYSIS A comprehensive electronic literature database search will be performed using three electronic databases: PubMed, Cochrane Library and Embase (Ovid interface). Our main outcomes of interest were overall survival, disease-free survival, relapse-free survival, invasive contralateral breast cancer, acceptability and grades 3 and 4 non-haematological toxicities in this study. We will assess the risk of bias and overall quality of evidence using the Cochrane Collaboration's tool and Grades of Recommendation, Assessment, Development and Evaluation, respectively. We will perform subgroup and sensitivity analyses in the selected trials. We will assess the three key assumptions of network meta-analysis: transitivity, consistency and homogeneity. ETHICS AND DISSEMINATION The protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database. Ethics approval and patient consent are not required for the network meta-analysis. The final results of this network meta-analysis will be disseminated through national and international conferences and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021278271.
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Affiliation(s)
- Qiancheng Hu
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center and Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Daoli Ye
- Gastric Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhao Xudong
- Laboratory of Animal Tumor Models, Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qingfeng Wang
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hongfeng Gou
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center and Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Luo
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Breast Center, West China Hospital, Sichuan University, Chengdu, China
- Multi-omics Laboratory of Breast Diseases, State Key Laboratory of Biotherapy, National Collaborative, Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Curigliano G, Cardoso F, Gnant M, Harbeck N, King J, Laenkholm AV, Penault-Llorca F, Prat A. PROCURE European consensus on breast cancer multigene signatures in early breast cancer management. NPJ Breast Cancer 2023; 9:8. [PMID: 36828834 PMCID: PMC9951144 DOI: 10.1038/s41523-023-00510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/26/2023] [Indexed: 02/26/2023] Open
Abstract
Breast cancer multigene signatures (BCMS) have changed how patients with early-stage breast cancer (eBC) are managed, as they provide prognostic information and can be used to select patients who may avoid adjuvant chemotherapy. Clinical guidelines make recommendations on the use of BCMS; however, little is known on the current use of BCMS in clinical practice. We conduct a two-round Delphi survey to enquire about current use and perceived utility for specific patient profiles, and unmet needs of BCMS. Overall, 133 panellists experienced in breast cancer across 11 European countries have participated, most using BCMS either routinely (66.2%) or in selected cases (27.1%). Our results show that BCMS are mainly used to assess the risk of recurrence and to select patients for adjuvant chemotherapy; notably, no consensus has been reached on the lack of utility of BCMS for selecting the type of chemotherapy to administer. Also, there are discrepancies between the recommended and current use of BCMS in clinical practice, with use in certain patient profiles for which there is no supporting evidence. Our study suggests that physician education initiatives are needed to ensure the correct use and interpretation of BCMS to, ultimately, improve management of patients with eBC.
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Affiliation(s)
- Giuseppe Curigliano
- European Institute of Oncology, IRCCS, Milan, Italy. .,Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy.
| | - Fatima Cardoso
- grid.421010.60000 0004 0453 9636Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - Michael Gnant
- grid.22937.3d0000 0000 9259 8492Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Nadia Harbeck
- grid.411095.80000 0004 0477 2585Breast Center, LMU University Hospital, Munich, Germany
| | - Judy King
- grid.437485.90000 0001 0439 3380Royal Free Hospital NHS Foundation Trust, London, UK
| | | | - Frédérique Penault-Llorca
- grid.494717.80000000115480420Centre de Lutte Contre le Cancer Jean Perrin, Imagerie Moléculaire et Stratégies Théranostiques, Université Clermont Auvergne, UMR 1240 INSERM-UCA, Clermont Ferrand, France
| | - Aleix Prat
- grid.10403.360000000091771775Hospital Clínic de Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
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Liu HP, Zhang JV, Wang D, Albrecht A, Steinhöfel K, Lai HM. Extended endocrine therapy in breast cancer: a basket of length-constraint feature selection metaheuristics to balance Type I against Type II errors. J Biomed Inform 2022; 131:104112. [DOI: 10.1016/j.jbi.2022.104112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/25/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
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Effect of Combining Traditional Chinese Medicine with Hormonal Therapy on Quality of Life and Tumor Markers of Prostate Cancer Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5061867. [PMID: 34691216 PMCID: PMC8528605 DOI: 10.1155/2021/5061867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
Objective To explore the effect of combining traditional Chinese medicine (TCM) with hormonal therapy on the quality of life and tumor markers of prostate cancer patients. Methods A total of 60 prostate cancer patients treated in Zibo Central Hospital from June 2017 to June 2021 were selected for the retrospective analysis study and divided into the control group and experimental group based on whether applying TCM treatment, with 30 cases each. The patients in the experimental group received the combined treatment of TCM and hormonal therapy, and those in the control group only accepted the hormonal therapy, so as to analyze their clinical efficacy and tumor marker levels after treatment. Results The patients' general information were not statistically different (P > 0.05); after treatment, the levels and ratios of total prostate-specific antigen (TPSA) and free prostate-specific antigen (FPSA) of patients in both groups were improved, and the experimental group obtained significantly lower TPSA and FPSA levels (P < 0.05) and higher TPSA/FPSA ratios (P < 0.05); the incidence of androgen-independent prostate cancer was significantly lower in the experimental group than in the control group (8 vs. 16, P < 0.05); in addition, the time to develop into the androgen-independent prostate cancer was longer in patients of the experimental group than those of the control group (P < 0.05); the treated patients in the experimental group obtained obviously higher Functional Assessment of Cancer Therapy-Prostate (FACT-P) quality of life scores and Karnofsky score (KPS) than those in the control group (P < 0.05), and the number of patients with recovered PSA levels was significantly higher in the experimental group than in the control group (P < 0.05). Conclusion Combining self-made TCM formula with hormonal therapy can effectively improve the levels of prostate tumor markers and postpone the progress of developing from prostate cancer to androgen-independent prostate cancer, which is conducive to promoting the patients' quality of life.
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