scholarly journals Individual Patient Data Meta-Analysis of Survival and Psychosomatic Self-Regulation from Published Prospective Controlled Cohort Studies for Long-Term Therapy of Breast Cancer Patients with a Mistletoe Preparation (Iscador)

2010 ◽  
Vol 7 (2) ◽  
pp. 157-166 ◽  
Author(s):  
R. Ziegler ◽  
Ronald Grossarth-Maticek

Mistletoe preparations such as Iscador are in common use as complementary/anthroposophic medications for many cancer indications, particularly for solid cancers. The efficacy is still discussed controversially. This paper presents an individual patient data meta-analysis of all published prospective matched-pair studies with breast cancer patients concerned with long-term application of a complementary/anthroposophic therapy with the mistletoe preparation Iscador. Six sets of data were available for individual patient meta-analysis of breast cancer patients, matched according to prognostic factors into pairs with and without mistletoe (Iscador) therapy. The main outcome measures were overall survival and psychosomatic self-regulation. Overall survival was almost significant in favor of the Iscador group in the combined data set of the randomized studies: estimate of the hazard ratio with 95% confidence interval 0.59 (0.34, 1.02). Overall survival was highly significant in the combined data set of the non-randomized studies: 0.43 (0.34, 0.56). In the combined analysis of the randomized studies, improvement of psychosomatic self-regulation, as a measure of autonomous coping with the disease, was highly significant in favor of the Iscador group: estimate of the median difference 0.45 (0.15, 0.80),P= 0.0051. The analyzed studies show that therapy with Iscador might prolong overall survival and improve psychosomatic self-regulation of breast cancer patients.

2017 ◽  
Vol 17 (2) ◽  
pp. 217-225 ◽  
Author(s):  
Kejia Hu ◽  
David Frederick Callen ◽  
Jiayuan Li ◽  
Hong Zheng

Studies have shown that vitamin D could have a role in breast cancer survival; however, the evidence of the relationship between patients’ vitamin D levels and their survival has been inconsistent. This meta-analysis explores possible dose-response relationships between vitamin D levels and overall survival by allowing for differences in vitamin D levels among populations of the various studies. Studies relating vitamin D (25-OH-D [25-hydroxyvitamin D]) levels in breast cancer patients with their survival were identified by searching PubMed and Embase. A pooled HR (hazard ratio) comparing the highest with the lowest category of circulating 25-OH-D levels were synthesized using the Mantel-Haenszel method under a fixed-effects model. A two-stage fixed-effects dose-response model including both linear (a log-linear dose-response regression) and nonlinear (a restricted cubic spline regression) models were used to further explore possible dose-response relationships. Six studies with a total number of 5984 patients were identified. A pooled HR comparing the highest with the lowest category of circulating 25-OH-D levels under a fixed-effects model was 0.67 (95% confidence interval = 0.56-0.79, P < .001). Utilizing a dose-response meta-analysis, the pooled HR for overall survival in breast cancer patients was 0.994 (per 1 nmol/L), Pfor linear trend < .001. At or above a 23.3 nmol/L threshold, for a 10 nmol/L, 20 nmol/L, or 25 nmol/L increment in circulating 25-OH-D levels, the risk of breast cancer overall mortality decreased by 6%, 12%, and 14%, respectively. There was no significant nonlinearity in the relationship between overall survival and circulating 25-OH-D levels. Our findings suggest that there is a highly significant linear dose-response relationship between circulating 25-OH-D levels and overall survival in patients with breast cancer. However, better designed prospective cohort studies and clinical trials are needed to further confirm these findings.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 528-528 ◽  
Author(s):  
Ivana Bozovic-Spasojevic ◽  
Dimitrios Zardavas ◽  
Evandro De Azambuja ◽  
Lieveke Ameye ◽  
Christos Sotiriou ◽  
...  

528 Background: Androgen receptor (AR) expression has been observed in ~70% of breast cancer (BC) patients, but its prognostic role is not established yet. To assess this we performed a meta-analysis of studies that evaluated the impact of AR on disease free survival (DFS) and/or on overall survival (OS) in early stage BC. Methods: Published studies were identified by an electronic search on PubMed using the MeSH terms "breast neoplasm" and "androgen receptor" (up to June 2012). Identified studies were assessed against the following criteria for inclusion in the analysis: early stage BC and reported results of AR status in correlation with clinical outcome. We report combined HRs with 95% confidence intervals (CI) using AR negative patients as reference. Results: Twenty studies were eligible for the meta-analysis out of 493 initially identified and 12 among them, including 6,525 patients, were considered as evaluable (i.e., reporting enough information to allow aggregation of results). AR positivity was associated with lower risk of relapse in all breast cancer patients, and better overall survival in both univariate (U) and multivariate (M) analysis. AR prognostic impact in different subtypes was also assessed (see Table). Conclusions: Our analysis demonstrated that AR delivers prognostic information overall, serving as a positive prognostic factor in early stage BC. Further studies are needed to delineate its prognostic impact within the different subtypes of the disease. [Table: see text]


2021 ◽  
Author(s):  
Zizhen Zhou ◽  
Xiancai Li ◽  
Dewu Liu

AbstractObjectiveThe aim of our study was to systematically evaluate the prognostic effects of various circrnas and to explore the prognostic value of circRNAs in breast cancer patients.MethodsA systematical search was conducted on PubMed, Scopus, EMBASE, and the Cochrane Library databases. Eligible studies reporting on the association among circRNAs and prognostic values of breast cancer patients were included. Fixed-effects and random effects models were used to calculate the pooled hazard ratio values of overall survival and disease free survival. In addition, funnel plots were used to qualitatively analyze the publication bias.Results28 studies were included in our meta-analysis. The pooled hazard ratio values of overall survival and disease free survival related to different circRNAs expression in breast cancer patients were 1.68 (1.44-1.97), 2.63 (1.95-3.53).We have identified a total of 28 circRNAs including 19 significantly up-regulated expression circRNAs and 9 significantly down-regulated expression circRNAs in BC(breast cancer) patients. Moreover, all of them revealed mechanisms and have the function of promoting or inhibiting the proliferation, metastasis or invasion of breast cancer cells by acting on the corresponding target.ConclusionOverall, specific circRNAs are significantly associated with the prognosis of BC patients and potentially eligible for the prediction of patients survival. It also provides a potential value for clinical decision-making development and may serve as a promising circRNAs-based target therapy waiting for further elucidation.


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