Comparative Efficacy and safety of new targeted therapies and immunotherapies for metastatic triple negative breast cancer: a network meta-analysis

ABSTRACT

Background

Several therapies directed at novel targets and also immunotherapies have recently shown promising results in advanced or metastatic TNBC. We aimed to compare the efficacy and safety of these new regimens for advanced or metastatic TNBC (mTNBC).

Methods

The PubMed, Embase, and Cochrane Library electronic databases were searched for phase III randomized trials. We conducted a network meta-analysis to compare the efficacy and safety of new targeted and immunotherapy regimens. Trial quality was assessed using the GRADE method. The comparative outcomes were progression-free survival, overall survival, and G3–4 adverse drug events (ADEs).

Results

Thirteen phase III randomized controlled trials were identified in the network meta-analysis. Olaparib significantly improved PFS in comparison with the pembrolizumab plus chemotherapy 1, atezolizumab plus nab-paclitaxel and pembrolizumab regimens. Sacituzumab yielded a significant improvement in OS over immunotherapies, veliparib, and chemotherapy alone, but no significantly superiority over pembrolizumab, olaparib, and talazoparib. The risk of ≥grade 3 ADEs associated with olaparib was significantly lower than the risks associated with the other regimens.

Conclusion

For mTNBC, sacituzumab had a better effect on overall survival, with comparatively high risk of SAE, whereas olaparib improved progression-free survival with a lower risk of SAE, particularly in those patients with BRCA mutations.

KEYWORDS:

• Targeted therapies and immunotherapies
• metastatic triple-negative breast cancer
• PARP inhibitors
• atezolizumab
• sacituzumab

Acknowledgments

We acknowledge with great appreciation to Dr. Henry WC Leung for his valuable and constructive expert opinions during the planning and development of this research work. We appreciate his willingness to contribute his time so generously.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization: A Chan, YS Tai; Data curation: J Leung, YS Tai; Methodology: A Chan, SY Wang; Software: J Leung, A Chan; Statistical analysis: HT Yip; Writing – original draft: A Chan, J Leung; Writing – review & editing: YC Hsu, J Leung.

All authors provided critical comments, edited the manuscript, and approved its final version. All authors have read and agreed to the published version of the manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14740338.2022.2116001

Additional information

Funding

This research was not funded.