Selection of breast cancer subtypes to improve benefits of intensive dose‑dense chemotherapy: A systematic meta‑analysis.

"the keywords 'breast cancer' 'intensive dose-dense chemotherapy' and their mesh terms were used (see details in data s1 )."

"Competing interests The authors declare that they have no competing interests."

"The present study was supported by National College Students Innovation and Entrepreneurship Training Program of Shenyang Pharmaceutical University (grant no. 202210163017), Science Foundation of Shenyang Pharmaceutical University (grant no. GGJJ2021107) and Scientific Research Fund of Liaoning Provincial Education Department (grant no. LJKQZ20222349)."

"The present network meta-analysis was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) () and the Cochrane Collaboration guidelines (). This systematic review was registered with the PROSPERO online system as no. CRD2022420351567 (). Breast cancer (BC) is the most commonly diagnosed cancer and the second leading cause of cancer mortality among women worldwide. A large number of patients experience recurrence and BC-associated mortality following adjuvant chemotherapy. The present study aimed to determine the most suitable pathological subtype of BC to benefit from intensive dose-dense (DD) chemotherapy. A total of four electronic databases were searched from inception up to March 10, 2023. Randomized controlled trials (RCTs) and retrospective studies comparing DD chemotherapy with standard chemotherapy in patients with BC were included. Pairwise random effects and network meta-analyses were performed to summarize efficacy and safety outcomes. A total of 27 original studies including 27,580 patients with BC were included. In terms of efficacy, the present study evaluated overall survival, disease-free survival, event-free survival, recurrence-free survival, pathological complete response and objective remission rate. Significant differences were identified in overall, hormone receptor+ (HR+) and HR− subgroups. Furthermore, from the network analysis, the HR+ and Her2− subgroups had the highest ranking, and these findings suggested that HR+/Her2− patients with BC should adhere to a treatment strategy including intensive DD chemotherapy, which is also characterized by an acceptable safety profile. In conclusion, patients with HR+ and Her2− BC were revealed to be the most suitable pathological type and are most likely to benefit from intense DD chemotherapy. The present study was registered with PROSPERO, CRD2022420351567."