Davari Majid, Amani Bahman, Mokarian Fariborz, Hoseini Mohsen, Akbarzadeh Arash, Heidarzadeh Khoramabadi Nastaran
Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran, & Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2017 Dec 16;31:88. doi: 10.14196/mjiri.31.88. eCollection 2017.
Trastuzumab in combination with chemotherapy has long been established as a standard treatment for HER2-positive patients in early stage breast cancer (BC). The present study aimed at assessing the effectiveness of trastuzumab adjuvant therapy in early stage BC in overall survival (OS) and disease-free survival (DFS). A systematic review and meta-analysis was performed to evaluate the effectiveness of trastuzumab adjuvant therapy. PubMed, Cochrane library, Scopus, Web of Science, and Embase databases were searched for relevant RCTs from the beginning to February 2017. Quality assessment of studies was conducted using the Cochrane Risk of Bias Tool. The desired outcomes were OS and DFS. A total of 1818 articles were identified first, however, only 11 studies were eligible to be included in this study. Our findings and meta-analysis results revealed that trastuzumab is effective in increasing OS (OS hazard ratio: -0.286 ± 0.049, 95%CI (-0.381, - 0.191)) and improving DFS (DFS hazard ratio: -0.419± 0.077, 95%CI (-0.569, -0.269)). The most serious but negligible side effect of trastuzumab is congestive heart failure. Adding trastuzumab as adjuvant therapy in early stages of BC in HER2 positive patients could increase OS and DFS of the patients effectively.
曲妥珠单抗联合化疗长期以来一直是早期乳腺癌（BC）HER2阳性患者的标准治疗方法。本研究旨在评估曲妥珠单抗辅助治疗在早期BC患者总生存期（OS）和无病生存期（DFS）方面的有效性。进行了一项系统评价和荟萃分析以评估曲妥珠单抗辅助治疗的有效性。检索了PubMed、Cochrane图书馆、Scopus、Web of Science和Embase数据库，以查找从开始到2017年2月的相关随机对照试验（RCT）。使用Cochrane偏倚风险工具对研究进行质量评估。预期结果为OS和DFS。首先共识别出1818篇文章，然而，只有11项研究符合纳入本研究的条件。我们的研究结果和荟萃分析结果显示，曲妥珠单抗在提高OS（OS风险比：-0.286±0.049，95%置信区间（-0.381，-0.191））和改善DFS（DFS风险比：-0.419±0.077，95%置信区间（-0.569，-0.269））方面有效。曲妥珠单抗最严重但可忽略不计的副作用是充血性心力衰竭。在HER2阳性患者的早期BC中添加曲妥珠单抗作为辅助治疗可有效提高患者的OS和DFS。
