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Title : A METAANALYSIS OF TAXANES, ANTITUMOR ANTIBIOTICS AND PLATINUM CONTAINING CHEMOTHERAPY REGIMENS IN THE MANAGEMENT OF METASTATIC BREAST CANCER
Authors : Soumadip Das, Rajat Rana, Aravinda Swami, Doreen Pon, C K Dhanapal, Sandra Leal
Abstract : The objective of present work is to compare Taxanes, antitumor antibiotics and platinum containing chemotherapy regimens in the management of metastatic breast cancer in terms of overall survival, objective response rate and time to progression. Cochrane Breast Cancer Group specialized register; Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and WHO International Clinical Registry platform were searched using the appropriate search strategy Selection criteria. Randomised trials comparing the Taxanes, antitumor antibiotics and platinum containing chemotherapy for either recurrent or newly diagnosed women with Metastatic Breast Cancer were included. Data were collected from published trials. Studies were assessed for eligibility and quality, and data were extracted by two independent reviewers. Hazard Ratios (HRs) were derived from time-to-event outcomes where possible, and a fixed effect model was used for meta-analysis. Response rates were analysed as dichotomous variables. 35 trials were included with sample size of 16272 patients with Advanced Metastatic Breast Cancer treated with either Antitumor Antibiotics or Platinum Regimens or Taxanes. The observed overall survival derived for a sample size of 2710 exposed to chemotherapy where as a comparator group of 2591 exposed other therapies. The overall risk ratio was 0.98(M-H, fixed, 95% CI; 0.95 to 1.01). Time to Progression for a sample size of 2613 exposed to chemotherapy in comparison to the comparator group of 2370 exposed to other therapies. The overall risk ratio was 1.01(M-H, fixed, 95% CI; 0.98 to 1.03). Tumor Response Rate derived for a sample size of 3037 exposed to chemotherapy in comparison to the comparator group of 2951 exposed to other therapies. The overall risk ratio was 1.15(M-H, fixed, 95% CI; 1.08 to 1.22). This study confirms several benefits of chemotherapy especially Taxanes, antitumor antibiotics and platinum regimen in metastatic breast cancer, but the selection of drug therapy must be based upon the presentation of the case.

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