Abstract
Background: We assessed the effect of bisphosphonates (BPs) on breast cancer (BCa) patient survival and explored how long the effect can persist after treatment. Methods: We performed a meta-analysis and trial sequential analysis (TSA) of prospective studies including randomized controlled trials (RCTs) and cohort studies and reported effect estimates with 95% confidence intervals (CIs). We performed extensive sensitivity analyses to assess the robustness of the findings.\ Results: Seventeen RCTs and eight cohorts with 81508 BCa patients were identified. A significant beneficial effect of BPs on BCa survival was found (RR, 0·725; 95%CI, 0·627-0·839), and TSA results also suggested firm evidence for this beneficial effect. Both summarized results from RCTs and cohorts provides firm evidence for this effect, though the effect estimates were stronger from cohorts than RCTs (RR, 0·892; 95%CI, 0·829-0·961; 0·570; 95%CI, 0·436-0·745; respectively). This beneficial effect was confirmed for bone-metastases (RR, 0·713; 95%CI, 0·602-0·843) and postmenopausal women (RR, 0·737; 95%CI, 0·640-0·850). Importantly, our results demonstrated that this beneficial effect retained at least 1-2 years after treatment completion (RR, 0·780; 95%CI, 0·638-0·954) and could persist for up to more than 4 years after treatment completion (RR, 0·906; 95%CI, 0·832-0·987). Extensive sensitivity analyses showed the robustness of our results. The GRADE quality of evidence was generally judged to be moderate to high. Conclusions: The present study provides firm evidence for a significant beneficial effect of BPs on BCa survival in patients with early-stage BCa, particularly for bone metastases and postmenopausal patients; and this effect retained at least 1-2 years after BP treatment completion. Systematic Review Registration: PROSPERO CRD42014014699. Funding Statement: This work was supported by the China Postdoctoral Science Foundation (grant number 2018M641875 to YPL); the Natural Science Foundation of Heilongjiang Province (grant number YQ2019H021to YPL); the National Key Research and Development Program of China (grant number 2017YFC0108602 to XDL). Declaration of Interests: None.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
