PDF(Pubmed)
Abstract：
This meta-analysis was designed to compare the efficacy and safety of gemcitabine-based regimens for the treatment advanced breast cancer (ABC). Altogether 15 studies involving 8195 ABC patients were retrieved for analysis. Compared with non-gemcitabine-based chemotherapies, patients receiving gemcitabine-based therapy exhibited better overall survival (OS), progression free survival (PFS), and objective response rate (ORR) (HR = 1.12, 95% CI 1.05 to 1.19; HR = 1.16, 95% CI 1.03 to 1.30; HR = 1.14, 95% CI 1.04 to 1.24). Grade 3/4 hematologic toxicity was significantly high but manageable in gemcitabine-based groups. Subgroup analysis revealed that patients with first-line gemcitabine-based chemotherapy had better OS (HR = 1.19, 95% CI 1.07 to 1.32), PFS (HR = 1.17, 95% CI 1.08 to 1.27), and ORR (RR = 1.16, 95% CI 1.02 to 1.32). In addition, additional gemcitabine chemotherapy also showed better OS (HR = 1.17, 95% CI 1.06 to 1.30), PFS (HR = 1.20, 95% CI 1.11 to 1.30) and ORR (RR = 1.23, 95% CI 1.06 to 1.42) than gemcitabine replacement therapy. Furthermore, patients receiving gemcitabine-taxanes-based regimens had better OS (HR = 1.17, 95% CI 1.06 to 1.28), PFS (HR = 1.12, 95% CI 1.04 to 1.20) and ORR (RR = 1.17, 95% CI 1.01 to 1.35) than patients with non-gemcitabine-taxanes-based chemotherapy. These findings indicate that gemcitabine combination regimens could serve as a promising regimen for ABC patients, though increased hematologic toxicity should be considered with caution.
摘要：
这项荟萃分析旨在比较基于吉西他滨的方案治疗晚期乳腺癌（ABC）的疗效和安全性。共检索了15项涉及8195名ABC患者的研究进行分析。与非吉西他滨化疗相比，接受以吉西他滨为基础的治疗的患者表现出更好的总生存期（OS），无进展生存期（PFS），和客观缓解率（ORR）（HR=1.12，95％CI1.05至1.19；HR=1.16，95％CI1.03至1.30；HR=1.14，95％CI1.04至1.24）。3/4级血液学毒性显著高，但在基于吉西他滨的组中是可控的。亚组分析显示，以吉西他滨为基础的一线化疗患者的OS较好（HR=1.19，95％CI1.07至1.32），PFS（HR=1.17，95%CI1.08至1.27），和ORR（RR=1.16，95%CI1.02至1.32）。此外,额外的吉西他滨化疗也显示出更好的OS（HR=1.17，95％CI1.06至1.30），PFS（HR=1.20，95％CI1.11至1.30）和ORR（RR=1.23，95％CI1.06至1.42）比吉西他滨替代疗法。此外，接受吉西他滨-紫杉烷类方案的患者OS较好(HR=1.17,95%CI1.06~1.28),PFS（HR=1.12，95％CI1.04至1.20）和ORR（RR=1.17，95％CI1.01至1.35）高于非吉西他滨紫杉烷类药物化疗患者。这些发现表明，吉西他滨联合方案可以作为ABC患者的有希望的方案，尽管血液学毒性增加应谨慎考虑。
