Universität zu Köln

Tesfamariam, Y., Jakob, T., Woeckel, A., Adams, A., Weigl, A., Monsef, I., Kuhr, K. and Skoetz, N. (2019). Adjuvant bisphosphonates or RANK-ligand inhibitors for patients with breast cancer and bone metastases: A systematic review and network meta-analysis. Crit. Rev. Oncol./Hematol., 137. S. 1 - 9. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1879-0461

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Abstract

Bone-modifying agents like bisphosphonates and receptor activator of nuclear factor kappa beta ligand (RANK-L) inhibitors are used as supportive treatments in breast cancer patients with bone metastases to prevent skeletal related events (SREs). Due to missing head-to-head comparisons, a network meta-analysis was performed to provide a hierarchy of these therapeutic options. Through a systematic literature search, 21 randomized controlled trials (RCTs) that fulfilled the inclusion criteria were identified. To prevent SREs, the ranking through P-scores showed denosumab (RR: 0.62; 95%CI: 0.50-0.76), zoledronic acid (RR: 0.72; 95%CI: 0.61-0.84) and pamidronate (RR: 0.76; 95%CI: 0.67-0.85) to be significantly superior to placebo. Due to insufficient or heterogeneous data, overall survival, quality of life, pain response and adverse events were not able to be analyzed within the network. Although data were sparse on adverse events, the risk of significant adverse events appeared low. The results of this review can therefore be used to formulate clinical studies more precisely in order to standardise and focus on patient-relevant outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Tesfamariam, Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jakob, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Woeckel, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Adams, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weigl, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Monsef, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Skoetz, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-149456
DOI:	10.1016/j.critrevonc.2019.02.004
Journal or Publication Title:	Crit. Rev. Oncol./Hematol.
Volume:	137
Page Range:	S. 1 - 9
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1879-0461
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SKELETAL-RELATED EVENTS; ZOLEDRONIC ACID; DOUBLE-BLIND; PROSTATE-CANCER; OSTEOLYTIC METASTASES; ORAL IBANDRONATE; CONTROLLED-TRIAL; EFFICACY; COMPLICATIONS; MECHANISMS Multiple languages Oncology; Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14945