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Dual HER2 Blockade versus a Single Agent in Trastuzumab-Containing Regimens for HER2-Positive Early Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Joint Authors
Yu, Liuwen
Fu, Fangmeng
Li, Jing
Huang, Meng
Zeng, Bangwei
Lin, Yuxiang
Mei, Qian
Lv, Jinxing
Wang, Chuan
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-13, 13 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-03-16
Country of Publication
Egypt
No. of Pages
13
Main Subjects
Abstract EN
Purpose.
Although trastuzumab is the standard of care for patients with human epidermal growth factor receptor 2 (HER2)- positive early breast cancer (EBC), drug resistance and disease relapse occur.
Therefore, we performed a meta-analysis to assess the efficacy and safety of trastuzumab-containing dual anti-HER2 therapy compared to trastuzumab alone.
Methods.
A systematic search was performed to identify eligible randomized controlled trials (RCTs).
Main outcomes including event-free survival/invasive disease-free survival (EFS/iDFS), overall survival (OS), and safety were considered.
Results.
Ten RCTs were included (15,284 patients).
Significant improvements were observed in both EFS/iDFS (HR 0.86, p=0.0003) and OS (HR 0.86, p=0.02) with trastuzumab-based dual anti-HER2 therapy, especially in adjuvant treatment, while in the neoadjuvant setting, dual-targeted therapy also achieved a substantial pathological complete response (pCR) benefit (HR 1.34, p=0.0002).
Subgroup analysis revealed that the EFS/iDFS benefit was slightly higher with trastuzumab plus pertuzumab or plus neratinib than trastuzumab plus lapatinib, while OS benefit was significant with trastuzumab plus lapatinib, but there were no subgroup differences (interaction test, p=0.80 and 0.24, resp.).
In addition, EFS/iDFS benefit was unrelated to hormone receptor status but pronounced in the lymph node-positive (LN+) subgroup, which should be interpreted cautiously for lacking interaction (p=0.18).
Besides, patients receiving dual therapy, especially with the lapatinib-containing regimen, experienced more toxicity, but no increase in cardiotoxicity.
Conclusions.
Despite being associated with more toxicity, trastuzumab-containing dual anti-HER2 therapy is superior to trastuzumab single agent for HER2-positive EBC independent of hormone receptor status.
The correlation between survival and LN status needs further verification.
Trastuzumab plus pertuzumab or plus neratinib is the preferred regimen with substantial efficacy and lower toxicity.
American Psychological Association (APA)
Yu, Liuwen& Fu, Fangmeng& Li, Jing& Huang, Meng& Zeng, Bangwei& Lin, Yuxiang…[et al.]. 2020. Dual HER2 Blockade versus a Single Agent in Trastuzumab-Containing Regimens for HER2-Positive Early Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Oncology،Vol. 2020, no. 2020, pp.1-13.
https://search.emarefa.net/detail/BIM-1188973
Modern Language Association (MLA)
Yu, Liuwen…[et al.]. Dual HER2 Blockade versus a Single Agent in Trastuzumab-Containing Regimens for HER2-Positive Early Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Oncology No. 2020 (2020), pp.1-13.
https://search.emarefa.net/detail/BIM-1188973
American Medical Association (AMA)
Yu, Liuwen& Fu, Fangmeng& Li, Jing& Huang, Meng& Zeng, Bangwei& Lin, Yuxiang…[et al.]. Dual HER2 Blockade versus a Single Agent in Trastuzumab-Containing Regimens for HER2-Positive Early Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Oncology. 2020. Vol. 2020, no. 2020, pp.1-13.
https://search.emarefa.net/detail/BIM-1188973
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1188973