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艾日布林与紫杉醇治疗乳腺癌的疗效和安全性比较:一项系统评价和荟萃分析

Comparative efficacy and safety of eribulin versus paclitaxel in breast cancer: a systematic review and meta-analysis.

作者信息

Zhang Jialin, Su Jingyang, Ni Cui, Lu Jinhua

机构信息

Department of Oncology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, China.

Department of General internal medicine, Tongde Hospital Affiliated to Zhejiang Chinese Medical University (Tongde Hospital of Zhejiang Province), Hangzhou, China.

出版信息

Future Oncol. 2024 Dec;20(40):3507-3517. doi: 10.1080/14796694.2024.2431479. Epub 2024 Nov 20.

DOI:10.1080/14796694.2024.2431479
PMID:39563608
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11776855/
Abstract

AIM

We conducted a meta-analysis of published randomized controlled trials to compare the effectiveness and safety of eribulin versus paclitaxel for patients with breast cancer.

METHODS

We systematically searched multiple databases including Cochrane, PubMed, Medline, and Embase. The primary outcomes analyzed were overall survival (OS), complete response (CR), partial response (PR), stable disease (SD), and adverse events (AEs). These outcomes were evaluated using RevMan5.3 software.

RESULTS

A total of 5 studies were included in the analysis. Compared to paclitaxel plus other chemotherapy drugs, eribulin plus other chemotherapy drugs not only extended the overall survival of patients but also improved the disease control rate (DCR) [risk ratio (RR) 0.98, (95% confidence intervals (CI): 0.70, 1.38),  = 0.92]. Hematological system diseases [RR 1.18 (95% CI: 1.07, 1.31),  = 0.002] were the most frequently observed adverse event with eribulin, while paclitaxel was more likely to cause nervous system lesion [RR 0.66 (95% CI: 0.54, 0.80),  < 0.0001].

CONCLUSION

Compared with paclitaxel plus other chemotherapy drugs, eribulin plus other chemotherapy drugs can also prolong the PFS and OS of BC patients. Our recommendation is to use eribulin plus other chemotherapy drugs to treat advanced BC and to continuously monitor and manage the drug-related adverse events.

摘要

目的

我们对已发表的随机对照试验进行了荟萃分析,以比较艾日布林与紫杉醇治疗乳腺癌患者的有效性和安全性。

方法

我们系统检索了多个数据库,包括Cochrane、PubMed、Medline和Embase。分析的主要结局包括总生存期(OS)、完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)和不良事件(AE)。使用RevMan5.3软件对这些结局进行评估。

结果

分析共纳入5项研究。与紫杉醇加其他化疗药物相比,艾日布林加其他化疗药物不仅延长了患者的总生存期,还提高了疾病控制率(DCR)[风险比(RR)0.98,(95%置信区间(CI):0.70,1.38),P = 0.92]。血液系统疾病[RR 1.18(95%CI:1.07,1.31),P = 0.002]是艾日布林最常观察到的不良事件,而紫杉醇更易引起神经系统损害[RR 0.66(95%CI:0.54,0.80),P < 0.0001]。

结论

与紫杉醇加其他化疗药物相比,艾日布林加其他化疗药物也可延长乳腺癌患者的无进展生存期(PFS)和总生存期(OS)。我们的建议是使用艾日布林加其他化疗药物治疗晚期乳腺癌,并持续监测和管理与药物相关的不良事件。

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本文引用的文献

1
Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.2022 年全球癌症统计数据:全球 185 个国家和地区 36 种癌症的发病率和死亡率全球估计数。
CA Cancer J Clin. 2024 May-Jun;74(3):229-263. doi: 10.3322/caac.21834. Epub 2024 Apr 4.
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Paclitaxel Inhibits KCNQ Channels in Primary Sensory Neurons to Initiate the Development of Painful Peripheral Neuropathy.紫杉醇通过抑制初级感觉神经元中的 KCNQ 通道来引发痛性周围神经病的发生。
Cells. 2022 Dec 15;11(24):4067. doi: 10.3390/cells11244067.
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A Randomized Controlled Phase 2 Study of Neoadjuvant Eribulin Versus Paclitaxel in Women with Operable Breast Cancer: The JONIE-3 Study.一项比较新辅助埃博霉素与紫杉醇治疗可手术乳腺癌女性疗效的随机对照 2 期研究:JONIE-3 研究。
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Breast Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology.《NCCN 肿瘤学临床实践指南:乳腺癌》第 3.2022 版
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Eribulin improved the overall survival from the initiation of first-line chemotherapy for HER2-negative advanced breast cancer: a multicenter retrospective study.厄瑞布林改善了 HER2 阴性晚期乳腺癌一线化疗起始时的总生存期:一项多中心回顾性研究。
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Pathomechanisms of Paclitaxel-Induced Peripheral Neuropathy.紫杉醇诱导的周围神经病变的发病机制
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Chemotherapy-Induced Peripheral Neuropathy: Epidemiology, Pathomechanisms and Treatment.化疗引起的周围神经病变:流行病学、发病机制与治疗
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Comparative effectiveness and safety of eribulin in advanced or metastatic breast cancer: a systematic review and meta-analysis.比较艾立布林治疗晚期或转移性乳腺癌的有效性和安全性:系统评价和荟萃分析。
Crit Rev Oncol Hematol. 2021 Jul;163:103375. doi: 10.1016/j.critrevonc.2021.103375. Epub 2021 Jun 2.
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Breast Cancer Res Treat. 2021 Jul;188(1):117-131. doi: 10.1007/s10549-021-06184-w. Epub 2021 Mar 25.