Systemic treatment of HER2-positive metastatic breast cancer: A systematic review

被引:16
作者
Wilcken, Nicholas [1 ]
Zdenkowski, Nicholas [2 ]
White, Michelle [4 ]
Snyder, Ray [5 ]
Pittman, Ken [12 ]
Mainwaring, Paul [13 ]
Green, Michael [6 ]
Francis, Prudence [7 ]
De Boer, Richard [8 ]
Colosimo, Maree [13 ]
Chua, Sue [9 ]
Chirgwin, Jacquie [10 ]
Beith, Jane [3 ]
Bell, Richard [11 ]
机构
[1] Westmead Hosp, Westmead, NSW, Australia
[2] Australia & New Zealand Breast Canc Trials Grp, Camperdown, NSW, Australia
[3] Chris OBrien Lifehouse, Sydney, NSW, Australia
[4] Cabrini Hosp, Melbourne, Vic, Australia
[5] St Vincents Hosp, Melbourne, Vic, Australia
[6] Western Hlth, Footscray, Vic, Australia
[7] Peter MacCallum Canc Ctr, Melbourne, Vic, Australia
[8] Royal Melbourne Hosp, Melbourne, Vic, Australia
[9] Epworth Eastern Hosp, Box Hill, Vic, Australia
[10] Box Hill Hosp, Box Hill, Vic, Australia
[11] Deakin Univ, Geelong, Vic 3217, Australia
[12] Queen Elizabeth Hosp, Woodville, SA 5011, Australia
[13] Mater Private Breast Canc Ctr, Brisbane, Qld, Australia
关键词
anti-HER2; agent; breast cancer; metastatic; review; systematic; TRASTUZUMAB PLUS DOCETAXEL; RANDOMIZED PHASE-II; QUALITY-OF-LIFE; 1ST-LINE THERAPY; COMBINATION-THERAPY; SURVIVAL ANALYSIS; SINGLE-AGENT; LAPATINIB L; TRIAL; CAPECITABINE;
D O I
10.1111/ajco.12206
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
AimWe aimed to systematically review and summarize data from the available clinical trials that examined the treatment of HER2-positive metastatic breast cancer. MethodsWe reviewed phase 2 and 3 studies in which an anti-HER2 agent was used in one or both arms of the study. While formal meta-analysis was not possible for such a heterogeneous group of trials, resulting forest plots outline some generalizable findings. ResultsThere is strong evidence that the addition of an anti-HER2 agent to standard chemo- or endocrine therapy improves clinically relevant measurable outcomes. There is also consistent evidence that initial treatment with trastuzumab alone (and subsequent use of a cytotoxic) is inferior to the initial combination of trastuzumab plus chemotherapy, and that either T-DM1 or dual anti-HER2 agents are superior to single anti-HER2 agent regimens. There is no strong evidence that the use of more than one cytotoxic agent together with an anti-HER2 agent confers any benefit over a single cytotoxic, anti-HER2 combination. ConclusionThis review provides a strong evidence base for current clinical practice with a discussion of treatment in the Australian setting.
引用
收藏
页码:1 / 14
页数:14
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