patmedfarПациентоориентированная медицина и фармацияPatient-Oriented Medicine and Pharmacy2949-1924LLC Izdatelstvo OKI10.37489/2949-1924-0017patmedfar-31Research ArticleСИСТЕМАТИЧЕСКИЙ ОБЗОР И МЕТААНАЛИЗSYSTEMATIC REVIEW AND META-ANALYSISАдъювантная гормональная терапия на ранней стадии эстрогенположительного рака молочной железы: систематический обзор и сетевой метаанализAdjuvant hormone therapy in early-stage estrogen-positive breast cancer: a systematic review and network meta-analysishttps://orcid.org/0000-0002-2164-8290БелоусовД. Ю.BelousovD. Yu.

Белоусов Дмитрий Юрьевич — генеральный директор.

Москва

Belousov D. Yu. — General Director.

Moscow

clinvest@mail.ruhttps://orcid.org/0000-0001-8201-7321ЧебердаА. Е.CheberdaA. E.

Чеберда Алексей Евгеньевич — исполнительный директор.

Москва

Cheberda A. E. — Executive Director.

Moscow

aecheberda@healtheconomics.ruООО «Центр фармакоэкономических исследований»РоссияCenter for Pharmacoeconomic Research LLCRussian Federation202307062023127584Copyright © Белоусов Д.Ю., Чеберда А.Е., 20232023Белоусов Д.Ю., Чеберда А.Е.Belousov D.Y., Cheberda A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pomph.ru/jour/article/view/31Актуальность

Актуальность. Адъювантная гормонотерапия женщин в постменопаузе на ранней стадии эстрогенположительного рака молочной железы (РМЖ) включает анастрозол, летрозол, тамоксифен, торемифен и эксеместан, однако наиболее эффективный лекарственный препарат не известен, а в этой ситуации роль адъювантной гормональной терапии становится особо дискутабельной.

Цель

Цель. Проведение непрямого сравнения антагонистов эстрогенов и ингибиторов ароматазы, применяемых у женщин в постменопаузальном периоде с ранней стадией эстрогенположительного РМЖ, посредством систематического поиска и отбора транзитивных данных из рандомизированных контролируемых исследований (РКИ) и последующего их количественного синтеза в сетевом метаанализе.

Методы

Методы. Мы провели систематический обзор в двух базах: MEDLINE и The Cochrane Central Register of Controlled Trials. Были рассмотрены полнотекстовые версии статей с РКИ для оценки сравнительной эффективности адъювантной гормональной монотерапии торемифеном, тамоксифеном, анастрозолом, летрозолом и эксеместаном у женщин на ранней стадии эстрогенположительного РМЖ в постменопаузе, ранее не получавших гормональную терапию. Эффективность оценивали по общей выживаемости (ОВ). Был проведён сетевой метаанализ с помощью программы NetMetaXL.

Результаты

Результаты. В результате систематического поиска мы отобрали 8 РКИ с участием 25167 пациентов. При проведении синтеза полученных данных с помощью сетевого метаанализа не было получено статистически значимых различий в показателях 5-летней ОВ между препаратами сравнения.

Заключение

Заключение. Нет клинически значимых различий в 5-летней ОВ между сравниваемыми препаратами адъювантной гормональной монотерапии на ранней стадии РМЖ.

Relevance

Relevance. Adjuvant hormonal therapy in postmenopausal women at an early-stage of estrogen-positive breast cancer (BC) includes anastrozole, letrozole, tamoxifen, toremifene, and exemestane, but the most effective drug is not known, and in this situation, the role of adjuvant hormonal therapy becomes especially debatable.

The purpose of the study

The purpose of the study. Conducting an indirect comparison of oestrogen antagonists and aromatase inhibitors used in postmenopausal women with early-stage estrogen-positive breast cancer through a systematic search and selection of transitive data from randomized controlled trials (RCTs), and their subsequent quantitative synthesis in a network meta-analysis.

Methods

Methods. We conducted a systematic review in two databases: MEDLINE and The Cochrane Central Register of Controlled Trials. Full-text versions of articles from RCTs were reviewed to evaluate the comparative efficacy of adjuvant hormonal monotherapy with toremifene, tamoxifen, anastrozole, letrozole, and exemestane in women with early-stage estrogen-positive postmenopausal breast cancer who had not previously received hormone therapy. Efficacy was assessed by overall survival (OS). A network meta-analysis was carried out using the NetMetaXL programme.

Results

Results. As a result of a systematic search, we selected 8 RCTs involving 25167 patients. When performing a synthesis of the obtained data using a network meta-analysis, no statistically significant differences in 5-year OS were obtained between the comparators.

Conclusions

Conclusions. There are no clinically significant differences in 5-year OS between the compared drugs of adjuvant hormonal monotherapy in early-stage breast cancer.

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The authors declare that there are no conflicts of interest present.