Title:Efficacy and Safety of Phosphatidylinositol 3-kinase Inhibitors for
Patients with Breast Cancer: A Systematic Review and Meta-analysis of
Randomized Controlled Trials
Volume: 24
Issue: 9
关键词:
乳腺癌,荟萃分析,磷脂酰肌醇3激酶抑制剂,系统评价,总生存期,无进展生存期。
摘要:
Background: Phosphatidylinositol 3-kinase (PI3K) inhibitors belong to the class of
drugs that inhibit the activity of the PI3K protein, which is commonly overexpressed in breast cancer
cells. However, there is a need to summarize the evidence to provide conclusive advice on the
benefit of PI3K inhibitors in breast cancer patients. Therefore, this review assessed the effectiveness
and safety of the PI3K inhibitors amongst breast cancer patients.
Methods: Searches were made in PubMed Central, EMBASE, MEDLINE, SCOPUS, CENTRAL,
WHO trial registry and Clinicaltrials.gov up to December 2022. Meta-analysis was executed using
the random-effects model. Pooled hazard ratio (HR)/risk ratio (RR) was reported with 95% confidence
intervals (CIs).
Results: In total, 13 studies were included in the analysis. Most were multi-country studies and
had a higher risk of bias. Regarding the efficacy parameters, pooled HR for progression-free survival
was 0.79 (95%CI: 0.67-0.92), pooled RR for complete response was 1.54 [95%CI: 1.14 to
2.09], partial response was 1.18 [95%CI: 0.87-1.61], overall response was 1.20 [95%CI:
0.93-1.56], stable disease was 1.09 [95%CI: 0.78-1.53], progressive disease was 0.80 [95%CI:
0.74 to 0.87], and clinical benefit was 1.08 [95%CI: 0.80-1.49]. For safety parameters, pooled RR
for hyperglycemia was 4.57 [95%CI: 3.15-6.62], and gastrointestinal toxicity was 1.82 [95%CI:
1.56 to 2.14].
Conclusion: PI3K inhibitors had better efficacy than the present standard of concern for patients
with breast cancer, especially among patients with PIK3CA mutations. Hence, clinicians and oncologists
can provide this drug for the target population with extra caution for diabetes patients.