Efficacy Of Vinorelbine-based Neoadjuvant Chemotherapy In Breast Cancer: A Meta-analysis Of Randomized Controlled Trials

Background: To compare the effects of vinorelbine-based neoadjuvantchemotherapy and vinorelbine-free regimens, this meta-analysis of all relevantrandomized controlled trials was performed to investigate the efficacy ofvinorelbine-based neoadjuvant chemotherapy in different settings for thetreatment of breast cancer. Methods: The PubMed and Embase databases weresearched for relevant publications reporting randomized controlled trialscomparing neoadjuvant chemotherapy with or without vinorelbine until July2013. Risk ratios/odds ratio and95%confidence intervals (CIs) were used toestimate the association between vinorelbine in neoadjuvant chemotherapy andvarious efficacy outcomes. Fixed-or random-effect models were adopted topool data in Stata program (Version12.0, Stata Corporation, College Station,Texas, USA). Result: Five trials with a total of1495patients were included inthis meta-analysis. Neoadjuvant chemotherapy vinorelbine-based was notassociated with significant improvement in clinical outcomes including: pathologic complete response (RR=1.016,95%CI0.738–1.399, p=0.922)；Overall response rate(RR=1.048,95%CI0.969–1.133, p=0.239);Breast-conserving surgery(BCS; RR=1.764,95%CI0.734–4.239, p=0.205).Interestingly, we found that pathologic response rate was also significantlyincreased in HER2-amplified tumors (RR=2.31,95%CI1.20–4.43, p=0.01)and hormone receptor negative (RR=0.488,95%CI0.263–0.908, p=0.023).Conclusions: The present study suggests that neoadjuvant chemotherapyvinorelbine-based was not significantly improving pCR, ORR and BCS.HER2-amplified and hormone receptor negative patients were significantlyassociated with pathologic response rate.