Efficacy of doxorubicin-loaded graphene nanoplatform chemo-photothermal therapy versus photothermal therapy alone for breast cancer xenograft tumors: a meta-analysis.

چکیده اصلی

OBJECTIVE: To systematically evaluate the efficacy of doxorubicin (DOX)-loaded graphene nanoplatform chemo-photothermal therapy (CPT) compared with photothermal therapy (PTT) alone on relative tumor volume (RTV) in breast cancer xenograft models and to summarize reported secondary safety and translational endpoints. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched for animal studies published from January 2010 to December 2025 investigating DOX-loaded graphene nanomaterial-mediated CPT in breast cancer xenograft tumors. Hedges' g was used as the effect size measure, and standardized mean differences (SMDs) were pooled using a random-effects model. Heterogeneity, publication bias, subgroup analyses, sensitivity analyses, and qualitatively reported secondary endpoints were assessed. RESULTS: Nine breast cancer xenograft studies were included, involving 46 animals in the CPT group and 46 in the PTT group. The pooled SMD was -2.20 (95% CI: -2.76 to -1.65, p < 0.0001), with negligible heterogeneity (I2 = 0.0%). Subgroup analyses showed no statistically significant differences by cell line, graphene type, or publication period (all p > 0.05). Leave-one-out sensitivity analyses yielded pooled SMDs from -2.09 to -2.37. Funnel plot inspection and Egger's test suggested mild small-study asymmetry, but Trim-and-Fill correction did not change the direction or significance of the result. Secondary endpoint extraction showed limited survival, toxicity, biodistribution, and clearance reporting, supporting short-term tolerability but not definitive clinical translation. CONCLUSION: DOX-loaded graphene nanoplatform CPT was associated with significantly greater suppression of RTV than PTT alone in breast cancer xenograft models. The evidence supports a robust preclinical antitumor association while highlighting the need for standardized survival, long-term toxicity, biodistribution, and elimination studies before clinical application.

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