Jiang Zhansheng, Yang Yanfang, Pan Zhanyu, Yue Zhensong, Li Ling
Department of Combined Chinese & Western Medicine, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin Key Laboratory of Cancer Prevention & Therapy, Tianjin 300060, China.
Department of Combined Chinese & Western Medicine, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin Key Laboratory of Cancer Prevention & Therapy, Tianjin 300060, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Dec 30;94(48):3854-8.
To compare the efficacy of lapatinib or lapatinib plus trastuzumab versus trastuzumab in the neoadjuvant therapy of human epidermal growth factor receptor 2 (HER-2) positive breast cancer.
MEDLINE database, American Society of Clinical Oncology (ASCO), San Antonio Breast Cancer Symposium (SABCS), European Society for Medical Oncology (ESMO) proceedings and China Biomedical Database were searched for literatures of trastuzumab or lapatinib in neoadjuvant therapy for breast cancer. There was no limit of language or time. A meta-analysis was performed for retrieved literatures meeting the inclusion criteria.
A total of 1 794 breast cancer patients from 5 clinical trials were included. And the regimens were lapatinib plus neoadjuvant chemotherapy (n = 719), trastuzumab plus neoadjuvant chemotherapy (n = 714) and both drugs plus neoadjuvant chemotherapy (n = 361). The rate of pathological complete remission (pCR) was lower in lapatinib group than that in trastuzumab group (28.2% vs 35.4%). And the difference was statistically significant (P = 0.004). The pCR rate was significantly higher in lapatinib plus trastuzumab therapy group than that in trastuzumab group (53.2% vs 38.1%, P < 0.001).
Lapatinib can not replace trastuzumab as a first-choice agent in neoadjuvant therapy of HER-2 positive breast cancer. Lapatinib plus trastuzumab achieves better pCR than trastuzumab so that it and may become a first-choice of neoadjuvant therapy for HER-2 positive breast cancer regardless of economic affordability for patients.
比较拉帕替尼单药或拉帕替尼联合曲妥珠单抗与曲妥珠单抗在人表皮生长因子受体2（HER-2）阳性乳腺癌新辅助治疗中的疗效。
检索MEDLINE数据库、美国临床肿瘤学会（ASCO）、圣安东尼奥乳腺癌研讨会（SABCS）、欧洲医学肿瘤学会（ESMO）会议记录以及中国生物医学数据库中关于曲妥珠单抗或拉帕替尼用于乳腺癌新辅助治疗的文献。不限语言和时间。对符合纳入标准的检索文献进行荟萃分析。
共纳入来自5项临床试验的1794例乳腺癌患者。治疗方案分别为拉帕替尼联合新辅助化疗（n = 719）、曲妥珠单抗联合新辅助化疗（n = 714）以及两种药物联合新辅助化疗（n = 361）。拉帕替尼组的病理完全缓解（pCR）率低于曲妥珠单抗组（28.2%对35.4%）。差异具有统计学意义（P = 0.004）。拉帕替尼联合曲妥珠单抗治疗组的pCR率显著高于曲妥珠单抗组（53.2%对38.1%，P < 0.001）。
在HER-2阳性乳腺癌新辅助治疗中，拉帕替尼不能替代曲妥珠单抗作为首选药物。拉帕替尼联合曲妥珠单抗的pCR效果优于曲妥珠单抗，因此无论患者经济承受能力如何，它都可能成为HER-2阳性乳腺癌新辅助治疗的首选方案。
