Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Relative Effectiveness of Neoadjuvant Chemotherapy Regimens for Loco-Regional Recurrence: A network Meta-analysis
Mona Pathak, Sada Nand Dwivedi, Bhaskar Thakur, Suryanarayan VS Deo, Sreenivas Vishnubhatla

Last modified: 2018-09-16

Abstract


Background

Effectiveness of Neoadjuvant Chemotherapy (NACT) depends on the used regimens. Most widely used NACT regimens are Anthracyclines, taxane and targeted therapy. The results of randomized controlled trials have reported contradictory findings regarding effectiveness of these regimens on Loco-regional recurrence (LRR). Further, no previous study has compared all the three regimens simultaneously. Hence, present study aims to compare relative effectiveness of all three regimens, i.e., Anthracycline; Taxane and targeted drugs of neoadjuvant therapy.

Materials and methods

A systematic review revealed seven eligible randomized controlled trials identified through PubMed and Cochrane database of controlled trials. The Risk of Bias was assessed by Cochrane Risk of Bias assessment tool. Comparison adjusted funnel plot was used to assess the publication bias. The network meta-analysis model was used to assess the relative effectiveness of these regimens in terms of LRR. The results are recorded as hazard ratio & 95% CI.

Results

Targeted therapies, i.e., Trastuzumab and Bevacizumab has significantly better rate of LRR in comparison to anthracycline and taxane together as well as anthracyclines or taxanes alone. Further, taxane and anthracycline together was found better than anthracycline alone.

Conclusions

For a better LRR free survival, suitable targeted therapy may be a better choice.