Intra-Arterial Therapies for Liver Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

B.M. Aarts*, F.M.G. Munoz, H. Wildiers, V.O. Dezentje, T.R. Baetens, W. Schats, M. Lopez-Yurda, R.C. Dresen, B.J.D.W. van der Veen, C.M. Deroose, G. Maleux, R.G.H. Beets-Tan, E.G. Klompenhouwer

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose Performing a systematic review and meta-analysis to assess the evidence of intra-arterial therapies in liver metastatic breast cancer (LMBC) patients. Methods A systemic literature search was performed in PubMed, EMBASE, SCOPUS for studies regarding intra-arterial therapies in LMBC patients. Full text studies of LMBC patients (n >= 10) published between January 2010 and December 2020 were included when at least one outcome among response rate, adverse events or survival was available. Response rates were pooled using generalized linear mixed models. A weighted estimate of the population median overall survival (OS) was obtained under the assumption of exponentially distributed survival times. Results A total of 26 studies (1266 patients) were included. Eleven articles reported on transarterial radioembolization (TARE), ten on transarterial chemoembolization (TACE) and four on chemo-infusion. One retrospective study compared TARE and TACE. Pooled response rates were 49% for TARE (95%CI 32-67%), 34% for TACE (95%CI 22-50%) and 19% for chemo-infusion (95%CI 14-25%). Pooled median survival was 9.2 months (range 6.1-35.4 months) for TARE, 17.8 months (range 4.6-47.0) for TACE and 7.9 months (range 7.0-14.2) for chemo-infusion. No comparison for OS was possible due to missing survival rates at specific time points (1 and 2 year OS) and the large heterogeneity. Conclusion Although results have to be interpreted with caution due to the large heterogeneity, the superior response rate of TARE and TACE compared to chemo-infusion suggests first choice of TARE or TACE in chemorefractory LMBC patients. Chemo-infusion could be considered in LMBC patients not suitable for TARE or TACE.
Original languageEnglish
Pages (from-to)1868-1882
Number of pages15
JournalCardiovascular and Interventional Radiology
Volume44
Issue number12
Early online date28 Jul 2021
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Breast neoplasm
  • Liver neoplasms
  • Intra-arterial infusion
  • Systematic review
  • Meta-analysis
  • HEPATIC ARTERIAL INFUSION
  • TRANSARTERIAL CHEMOEMBOLIZATION TACE
  • SINGLE-CENTER EXPERIENCE
  • Y-90 RADIOEMBOLIZATION
  • PREDICTS SURVIVAL
  • MITOMYCIN-C
  • MICROSPHERES
  • OUTCOMES
  • CAPECITABINE
  • CHEMOTHERAPY

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