Latif Farah, Bint Abdul Jabbar Hira, Malik Hamna, Sadaf Humaira, Sarfraz Azza, Sarfraz Zouina, Cherrez-Ojeda Ivan
Research and Publications, Fatima Jinnah Medical University, Lahore, Pakistan.
Research, King Edward Medical University, Lahore, Pakistan.
Expert Rev Anticancer Ther. 2022 Feb;22(2):229-235. doi: 10.1080/14737140.2022.2023011. Epub 2022 Jan 24.
The approval of anti-PD-L1 drugs, including atezolizumab/pembrolizumab in triple-negative breast cancer (TNBC), potentially improveme treatment regimens available for TNBC.
We conducted a meta-analysis to review the efficacy of atezolizumab/pembrolizumab for the treatment of TNBC in both the adjuvant and neoadjuvant settings. We calculated standardized mean difference (SMD) for the associations of progression-free survival (PFS) and overall survival (OS) and odds ratios (ORs) to estimate objective response rate (ORR) and pathological complete response (pCR), using 95% confidence intervals (CIs).
Six clinical trials comprising 3612 patients were included. For adjuvant therapies, the ORR (OR = 1.26, P = 0.04) of atezolizumab/pembrolizumab plus chemotherapy was higher in the intention to treat (ITT) arms than the placebo groups in TNBC. A positive effect size was found for PFS in the ITT arms (d = 1.55, P < 0.001). The atezolizumab plus chemotherapy group had a positive effect size for OS compared to control groups (d = 0.52, P < 0.001). In the neoadjuvant setting, patients in ITT arms had higher pCR rates than the control groups (OR = 1.61, P = 0.001).
We collate evidence of atezolizumab/pembrolizumab as viable therapeutics among patients with TNBC with PD-L1 subgroups deriving higher benefits.
抗程序性死亡配体1（PD-L1）药物（包括阿替利珠单抗/帕博利珠单抗）获批用于三阴性乳腺癌（TNBC）治疗，可能会改善TNBC的现有治疗方案。
我们进行了一项荟萃分析，以评估阿替利珠单抗/帕博利珠单抗在辅助和新辅助治疗环境中治疗TNBC的疗效。我们计算了无进展生存期（PFS）和总生存期（OS）关联的标准化均数差（SMD）以及比值比（OR），以估计客观缓解率（ORR）和病理完全缓解率（pCR），使用95%置信区间（CI）。
纳入了6项包含3612例患者的临床试验。对于辅助治疗，在TNBC的意向性治疗（ITT）组中，阿替利珠单抗/帕博利珠单抗联合化疗的ORR（OR = 1.26，P = 0.04）高于安慰剂组。在ITT组中发现PFS有正向效应量（d = 1.55，P < 0.001）。与对照组相比，阿替利珠单抗联合化疗组的OS有正向效应量（d = 0.52，P < 0.001）。在新辅助治疗环境中，ITT组患者的pCR率高于对照组（OR = 1.61，P = 0.001）。
我们整理了阿替利珠单抗/帕博利珠单抗作为TNBC患者可行治疗方法的证据，其中PD-L1亚组患者获益更大。
