Efficacy and Safety of Atezolizumab Monotherapy or Combined Therapy With Chemotherapy in Patients With Metastatic Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Publisher Pubmed



Alimohammadi M¹ ; Faramarzi F² ; Mafi A³ ; Mousavi T^{4, 5} ; Rahimi A⁶ ; Mirzaei H⁷ ; Asemi Z⁷ Show Affiliations
Source: Current Pharmaceutical Design Published:2023

Abstract

Introduction: Several successful attempts have been recorded with PD-L1 blockade via atezoli-zumab monotherapy or combination therapy with chemotherapy in patients with metastatic triple-negative breast cancer (mTNBC). Due to the lack of a large-scale study, we present a meta-analysis aimed at evaluat-ing the safety and efficacy of this promising strategy in patients with mTNBC. Methods: A comprehensive literature search was conducted using electronic databases to identify eligible RCTs. Twelve studies, including 2479 mTBNC patients treated with atezolizumab monotherapy or in combination with chemotherapy, were included up to January 2022. The PRISMA checklist protocol and the I2 sta-tistic were applied for quality assessment and heterogeneity tests of the selected trials, respectively. Fixed and random-effects models were estimated based on the heterogeneity tests, and statistical analysis was performed using CMA. Results: Our pooled findings demonstrated that the median overall survival (OS) and progression-free survival (PFS) were 16.526 and 5.814 months in mTNBC patients, respectively. Furthermore, when comparing efficacy indicators between PD-L1-positive and PD-L1-negative groups, mTNBC patients with PD-L1 had better OS, PFS, and ORR than PD-L1-negative patients. Also, the immune-related adverse event incident for alope-cia was higher (51.9%) than other complications across atezolizumab therapy. Conclusion: Moreover, the pooled analysis indicated that the overall rate of lung metastasis following ate-zolizumab therapy was 42.8%, which was higher than the rates of metastasis in bone (26.9%), brain (5.4%), and lymph node (6.5%). Atezolizumab showed a manageable safety profile and had promising and durable anti-tumor efficacy in TMBC patients. Higher PD-L1 expression may be closely correlated with better clinical efficacy. © 2023 Bentham Science Publishers.