Study summary · research use only
Breast cancer (metastatic)
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This systematic review examined treatments for metastatic breast cancer in humans. The authors state that median survival from metastatic breast cancer is 12 months without treatment, though young people can survive up to 20 years. They searched Medline, Embase, The Cochrane Library, and other databases up to June 2006 and included harms alerts from the FDA and MHRA, finding 63 systematic reviews, RCTs, or observational studies meeting inclusion criteria. The review presents information on interventions including anthracycline-based non-taxane chemotherapy, bisphosphonates, capecitabine or vinca alkaloids for anthracycline-resistant disease, chemotherapy plus trastuzumab, combined gonadorelin analogues plus tamoxifen, hormonal treatment with antioestrogens or progestins, ovarian ablation, selective aromatase inhibitors, radiotherapy, surgical resection, tamoxifen, and taxane-based chemotherapy, addressing first- and second-line questions and treatment of bone, spinal cord, and cerebral or choroidal metastases.
Abstract
Median survival from metastatic breast cancer is 12 months without treatment, but young people can survive up to 20 years with the disease, whereas in other metastatic cancers this would be considered unusual. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of first-line hormonal treatment? What are the effects of second-line hormonal treatment in women who have not responded to tamoxifen? What are the effects of first-line chemotherapy? What are the effects of first-line chemotherapy in combination with a monoclonal antibody? What are the effects of second-line chemotherapy? What are the effects of treatments for bone metastases? What are the effects of treatments for spinal cord metastases? What are the effects of treatments for cerebral or choroidal metastases? We searched: Medline, Embase, The Cochrane Library and other important databases up to June 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 63 systematic reviews, RCTs, or observational studies that met our inclusion criteria. In this systematic review we present information relating to the effectiveness and safety of the following interventions: anthracycline-based non-taxane combination chemotherapy regimens; bisphosphonates; capecitabine or semisynthetic vinca alkaloids for anthracycline-resistant disease; chemotherapy plus monoclonal antibody (trastuzumab); classical non-taxane combination chemotherapy; combined gonadorelin analogues plus tamoxifen; hormonal treatment with antioestrogens (tamoxifen) or progestins; intrathecal chemotherapy; non-anthracycline-based regimens; non-taxane combination chemotherapy; ovarian ablation; radiation sensitisers; radiotherapy (alone, or plus appropriate analgesia, or plus high-dose corticosteroids); selective aromatase inhibitors; chemotherapy (standard, or high dose); surgical resection; tamoxifen; and taxane-based combination chemotherapy.
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