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Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36480 cases.
Lin-Yu Xia
First Affiliated Hospital of Chengdu Medical College
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4802-2359
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Background: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC.
Methods: A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC.
Results: A total of nine studies involving 36480 patients met the selection criteria. Among them,10728 (29.41%) received NACT, and 25752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23-0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95%CI = 1.25-2.02; P=0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95%CI = 0.54-1.34; P=0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95%CI = 0.29-0.98; P=0.04) and DFS (HR = 0.52; 95%CI = 0.29-0.94; P=0.03), while the OS (HR = 1.18; 95%CI = 1.09-1.28; P<0.0001) and DFS (HR = 2.36; 95%CI = 1.42-3.89; P=0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. Conclusion: These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS. and it turns to be opposite when patients receiving NACT with RD.
Keywords
Triple-negative breast cancer, neoadjuvant, Adjuvant chemotherapy, Survival Outcomes, Meta-analysis
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CURRENT STATUS: Published
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Posted 06 Jun, 2020
Published
On 15 Jun, 2020
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On 02 Jun, 2020
Editorial decision: Accept
On 02 Jun, 2020
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On 01 Jun, 2020
Editor invited
On 01 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 07 May, 2020
Review #2 received
Received 30 Apr, 2020
Review #3 received
Received 30 Apr, 2020
Reviewer #3 agreed
On 30 Apr, 2020
Reviewer #2 agreed
On 22 Apr, 2020
Review #1 received
Received 14 Apr, 2020
Reviewer #1 agreed
On 09 Apr, 2020
Reviewers invited
Invitations sent on 02 Apr, 2020
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On 01 Apr, 2020
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On 31 Mar, 2020
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On 31 Mar, 2020
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This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36480 cases.
Lin-Yu Xia
First Affiliated Hospital of Chengdu Medical College
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4802-2359
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 06 Jun, 2020
Published
On 15 Jun, 2020
No community comments so far
Editor assigned
On 02 Jun, 2020
Editorial decision: Accept
On 02 Jun, 2020
Submission checks complete
On 01 Jun, 2020
Editor invited
On 01 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 07 May, 2020
Review #2 received
Received 30 Apr, 2020
Review #3 received
Received 30 Apr, 2020
Reviewer #3 agreed
On 30 Apr, 2020
Reviewer #2 agreed
On 22 Apr, 2020
Review #1 received
Received 14 Apr, 2020
Reviewer #1 agreed
On 09 Apr, 2020
Reviewers invited
Invitations sent on 02 Apr, 2020
Editor assigned
On 01 Apr, 2020
Submission checks complete
On 31 Mar, 2020
Editor invited
On 31 Mar, 2020
First submitted
On 30 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Background: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC.
Methods: A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC.
Results: A total of nine studies involving 36480 patients met the selection criteria. Among them,10728 (29.41%) received NACT, and 25752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23-0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95%CI = 1.25-2.02; P=0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95%CI = 0.54-1.34; P=0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95%CI = 0.29-0.98; P=0.04) and DFS (HR = 0.52; 95%CI = 0.29-0.94; P=0.03), while the OS (HR = 1.18; 95%CI = 1.09-1.28; P<0.0001) and DFS (HR = 2.36; 95%CI = 1.42-3.89; P=0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. Conclusion: These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS. and it turns to be opposite when patients receiving NACT with RD.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5