Secondary Risk-Reducing Strategies for Contralateral Breast Cancer in BRCA1/2 Variant Carriers: A Systematic Review and Meta-analysis.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-11-29 DOI:10.1007/s12325-024-03054-x

Jing Yu, Shan Jiang, Taoran Liu, Yangyang Gao, Xinyang Ma, Ginenus Fekadu, Yunqiu Xia, Bonny Parkinson, Wai-Kit Ming, Yuanyuan Gu

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Abstract

Introduction: Breast cancer poses significant challenges, especially the increased risk of contralateral breast cancer (CBC) in BRCA1/2 variant carriers. This study systematically reviews and analyzes the effectiveness of secondary risk-reducing strategies for CBC in BRCA1/2 carriers.

Methods: A systematic review and meta-analysis were conducted from January 2000 to December 2023, including RCTs, cohort, or case-control studies involving BRCA carriers with unilateral breast cancer. Random-effects models were used for odds ratios (ORs) on CBC incidence and hazard ratios (HRs) for overall survival (OS), with bias assessed via the Newcastle-Ottawa Scale.

Results: A total of 23,840 participants from 26 studies were included. Secondary risk-reducing interventions reduced CBC incidence by 38% [OR 0.62, 95% confidence interval (CI) 0.57-0.68] and improved OS by 45% (HR 0.55, 95% CI 0.46-0.67). Subgroup analyses showed differences by BRCA type, menopausal status, and treatment duration. For BRCA1 carriers, chemotherapy was most effective, while, for BRCA2, it was endocrine therapy. Postmenopausal interventions reduced CBC by 47% (OR 0.53, 95% CI 0.40-0.71), while premenopausal carriers saw a 34% reduction (OR 0.66, 95% CI 0.53-0.82). Tamoxifen's effect diminished over time.

Conclusion: Secondary prophylaxis reduces CBC and improves OS in BRCA1/2 carriers, with variations by genetic and physiological factors. These findings underscore the need for personalized strategies, considering menopausal status and treatment duration.

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.