Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis
Background: A systematic review and meta-analysis was conducted to assess breast cancer (BC) outcomes among patients with early-stage hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) BC, receiving adjuvant endocrine therapy. Methods: Randomized controlled tr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977621000230 |
| _version_ | 1818972458364960768 |
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| author | Elizabeth M. Salvo Abril Oliva Ramirez Jenilee Cueto Ernest H. Law Aaron Situ Chris Cameron Imtiaz A. Samjoo |
| author_facet | Elizabeth M. Salvo Abril Oliva Ramirez Jenilee Cueto Ernest H. Law Aaron Situ Chris Cameron Imtiaz A. Samjoo |
| author_sort | Elizabeth M. Salvo |
| collection | DOAJ |
| description | Background: A systematic review and meta-analysis was conducted to assess breast cancer (BC) outcomes among patients with early-stage hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) BC, receiving adjuvant endocrine therapy. Methods: Randomized controlled trials (RCTs) and real-world evidence (RWE) studies were identified using Ovid MEDLINE®, Embase, and Evidence-Based Medicine Reviews. Clinical and methodological similarities including alignment of outcome definitions with standardized definitions for efficacy endpoints criteria were assessed to evaluate feasibility of conducting a meta-analysis. Where feasible, 5-year probabilities of BC recurrence or death were estimated using a Bayesian hierarchical arm-based model. Results: Of 21 included studies, 8 RCTs and 4 RWE studies reported outcome data of interest. There was heterogeneity in outcome reporting, as well as variation in recurrence risk amongst studies with aligned reporting. Of the 12 studies, 10 were considered for inclusion in a meta-analysis of BC recurrence or death. Only a subgroup analysis of node-positive patients (3 studies; n = 7307) was deemed feasible. The 5-year probability of BC recurrence or death was 17.2% (95% credible interval: 14.6%–20.3%). Conclusion: Although studies reporting recurrence outcomes were limited, there remains a high risk of BC recurrence, especially among node-positive patients. Approximately 1 in 6 women with node-positive HR+/HER2- early-stage BC receiving endocrine therapy experience recurrence or death within 5-years of initiating treatment, suggesting a need for novel treatments for this population. |
| first_indexed | 2024-12-20T15:08:35Z |
| format | Article |
| id | doaj.art-0068c01cb048400598bbafcd82b18e2a |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-12-20T15:08:35Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-0068c01cb048400598bbafcd82b18e2a2022-12-21T19:36:23ZengElsevierBreast1532-30802021-06-0157517Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysisElizabeth M. Salvo0Abril Oliva Ramirez1Jenilee Cueto2Ernest H. Law3Aaron Situ4Chris Cameron5Imtiaz A. Samjoo6EVERSANA, Burlington, Ontario, CanadaEVERSANA, Burlington, Ontario, CanadaPatient & Health Impact, Pfizer Inc, New York, NY, USAPatient & Health Impact, Pfizer Inc, New York, NY, USAEVERSANA, Burlington, Ontario, CanadaEVERSANA, Sydney, Nova Scotia, CanadaEVERSANA, Burlington, Ontario, Canada; Corresponding author. EVERSANA, 204-3228 South Service Road, Burlington, L7N 3H8, Ontario, Canada.Background: A systematic review and meta-analysis was conducted to assess breast cancer (BC) outcomes among patients with early-stage hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) BC, receiving adjuvant endocrine therapy. Methods: Randomized controlled trials (RCTs) and real-world evidence (RWE) studies were identified using Ovid MEDLINE®, Embase, and Evidence-Based Medicine Reviews. Clinical and methodological similarities including alignment of outcome definitions with standardized definitions for efficacy endpoints criteria were assessed to evaluate feasibility of conducting a meta-analysis. Where feasible, 5-year probabilities of BC recurrence or death were estimated using a Bayesian hierarchical arm-based model. Results: Of 21 included studies, 8 RCTs and 4 RWE studies reported outcome data of interest. There was heterogeneity in outcome reporting, as well as variation in recurrence risk amongst studies with aligned reporting. Of the 12 studies, 10 were considered for inclusion in a meta-analysis of BC recurrence or death. Only a subgroup analysis of node-positive patients (3 studies; n = 7307) was deemed feasible. The 5-year probability of BC recurrence or death was 17.2% (95% credible interval: 14.6%–20.3%). Conclusion: Although studies reporting recurrence outcomes were limited, there remains a high risk of BC recurrence, especially among node-positive patients. Approximately 1 in 6 women with node-positive HR+/HER2- early-stage BC receiving endocrine therapy experience recurrence or death within 5-years of initiating treatment, suggesting a need for novel treatments for this population.http://www.sciencedirect.com/science/article/pii/S0960977621000230Early breast cancerAdjuvant endocrine therapyRecurrence riskRecurrence-free survivalSystematic literature reviewMeta-analysis |
| spellingShingle | Elizabeth M. Salvo Abril Oliva Ramirez Jenilee Cueto Ernest H. Law Aaron Situ Chris Cameron Imtiaz A. Samjoo Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis Breast Early breast cancer Adjuvant endocrine therapy Recurrence risk Recurrence-free survival Systematic literature review Meta-analysis |
| title | Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis |
| title_full | Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis |
| title_fullStr | Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis |
| title_full_unstemmed | Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis |
| title_short | Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis |
| title_sort | risk of recurrence among patients with hr positive her2 negative early breast cancer receiving adjuvant endocrine therapy a systematic review and meta analysis |
| topic | Early breast cancer Adjuvant endocrine therapy Recurrence risk Recurrence-free survival Systematic literature review Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0960977621000230 |
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