Evidence mapPaperPMID 28752187Full record

SynthesisBreast cancer research and treatment2017

Systematic review and network meta-analysis comparing palbociclib with chemotherapy agents for the treatment of postmenopausal women with HR-positive and HER2-negative advanced/metastatic breast cancer.

Florence R Wilson, Abhishek Varu, Debanjali Mitra, Chris Cameron, Shrividya Iyer

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Breast cancer research and treatment, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Florence R WilsonCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada.
Abhishek VaruCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada.
Debanjali MitraPfizer, Inc., New York, NY, USA.
Chris CameronCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada. ccameron@cornerstone-research.com.
Shrividya IyerPfizer, Inc., New York, NY, USA.
Pfizer (United States) · US

Funding

NCI NIH HHS P01 CA142538
6 · The paper itself

Abstract

purposeTo compare palbociclib + letrozole and palbociclib + fulvestrant with chemotherapy agents in postmenopausal women with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced/metastatic breast cancer (ABC/MBC) who had no prior systemic treatment for advanced disease (first line) or whose disease progressed after prior endocrine therapy or chemotherapy (second line).

methodsA systematic search identified randomized controlled trials (RCTs) published from January 2000 to January 2016 that compared endocrine-based therapies, chemotherapy agents, and/or chemotherapy agents + biological therapies in the first- and second-line treatment of postmenopausal women with HR+/HER2- ABC/MBC. The main outcome of interest was progression-free survival (PFS)/time to progression (TTP). Bayesian network meta-analyses (NMAs) and pairwise meta-analyses were conducted. Heterogeneity and inconsistency were assessed.

resultsSixty RCTs met eligibility criteria and were stratified by line of therapy. In the first line, palbociclib + letrozole showed statistically significant improvements in PFS/TTP versus capecitabine [intermittent: HR 0.28 (95% CrI 0.11-0.72)] and mitoxantrone [HR 0.28 (0.13-0.61)], and trended toward improvements versus paclitaxel [HR 0.59 (0.19-1.96)], docetaxel [HR 0.51 (0.14-2.03)] and other monotherapy or combination agents (HRs ranging from 0.24 to 0.99). In the second line, palbociclib + fulvestrant showed statistically significant improvements in PFS/TTP versus capecitabine [intermittent: HR 0.28 (0.13-0.65)], mitoxantrone [HR 0.26 (0.12-0.53)], and pegylated liposomal doxorubicin [HR 0.19 (0.07-0.50)], and trended toward improvements versus paclitaxel [HR 0.48 (0.16-1.44)], docetaxel [HR 0.71 (0.24-2.13)] and other monotherapy or combination agents (HRs ranging from 0.23-0.89). NMA findings aligned with direct evidence and were robust to sensitivity analyses.

conclusionsPalbociclib + letrozole and palbociclib + fulvestrant demonstrate trends in incremental efficacy compared with chemotherapy agents for the first- and second-line treatment of HR +/HER2- ABC/MBC.

Indexed as

PostmenopauseAge FactorsAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsDisease ProgressionErb-b2 Receptor Tyrosine KinasesFemaleHumansNeoplasm MetastasisNeoplasm StagingPiperazinesPyridinesRandomized Controlled Trials as TopicReceptors, EstrogenReceptors, ProgesteroneRetreatmentErb-b2 Receptor Tyrosine KinasespalbociclibPiperazinesPyridinesReceptors, EstrogenReceptors, ProgesteroneAdvanced/metastatic breast cancerChemotherapyNetwork meta-analysisPalbociclibProgression-free survivalTime to progression

Identifiers

PMID28752187
PMCPMC5645434
OpenAlexW2740803632

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.