Identifying the optimal therapeutics for patients with hormone receptor- positive, HER2-positive advanced breast cancer: a systematic review and network meta-analysis

被引：4

作者：

Wang, Y. ^{[1
]}

Xu, H. ^{[1
]}

Han, Y. ^{[1
]}

Wu, Y. ^{[1
]}

Sa, Q. ^{[1
]}

Wang, J. ^{[1
,2
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Clin Res Ctr Canc, Canc Hosp, Dept Med Oncol,Natl Canc Ctr, Beijing, Peoples R China

[2] Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Clin Res Ctr Canc, Dept Med Oncol,Natl Canc Ctr, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China

来源：

ESMO OPEN | 2023年 / 8卷 / 03期

关键词：

metastatic breast cancer; hormone receptor positive; human epidermal growth factor receptor 2 positive; efficacy; network meta-analysis; GROWTH-FACTOR RECEPTOR; PHASE-III TRIAL; LAPATINIB PLUS CAPECITABINE; OPEN-LABEL; TRASTUZUMAB EMTANSINE; DOUBLE-BLIND; ADJUVANT CHEMOTHERAPY; NEOADJUVANT THERAPY; 1ST-LINE TREATMENT; ENDOCRINE THERAPY;

D O I：

10.1016/j.esmoop.2023.101216

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+) breast cancer is a distinct subtype with different prognosis and response to treatment. HER2-targeted therapy is currently recommended for patients with HR+/HER2+ advanced breast cancer. However, there is debate over which drugs to add on the basis of HER2 blockade yield the optimal efficacy. This systematic review and network meta-analysis was conducted to solve the problem.Methods: Eligible randomized controlled trials (RCTs) comparing different interventions in HR+/HER2+ metastatic breast cancer were included. The outcomes of interest included progression-free survival (PFS), overall survival (OS) and treatment-related adverse events (TRAEs). Pooled hazard ratios or odds ratios with credible intervals (CrIs) were calculated to estimate the predefined outcomes. The optimal therapeutics were identified by comparing the surface under the cumulative ranking curves (SUCRA).Results: Totally, 23 literatures of 20 RCTs were included. Regarding PFS, significant differences were detected between single or dual HER2 blockade plus endocrine therapy (ET) versus ET alone and dual HER2 blockade plus ET versus physician's choice. Trastuzumab, pertuzumab plus chemotherapy significantly improved PFS than trastuzumab plus chemotherapy (hazard ratio 0.69, 95% CrI 0.50-0.92). The SUCRA values suggested the relatively better efficacy of dual HER2-targeted therapy plus ET (86%-91%) than chemotherapy (62%-81%) in prolonging PFS and OS. The HER2 blockade-containing regimens showed similar safety profiles in eight documented TRAEs. Conclusions: Prominent status of dual-targeted therapy for patients with HR+/HER2+ metastatic breast cancer was revealed. Compared with chemotherapy-containing regimens, the ET-containing ones showed better efficacy and similar safety profiles, which could be recommended in clinical practice.

引用

页数：9

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