Henan Key Laboratory of Cancer Epigenetics, Cancer hospital, The First Affiliated Hospital, College of Clinical Medicine, Medical College of Henan University of Science and Technology, Luoyang, China.
Medical College, Henan University of Science and Technology, Luoyang, China.
Technol Cancer Res Treat. 2020 Jan-Dec;19:1533033820960721. doi: 10.1177/1533033820960721.
To investigate the pathologic complete response (pCR) rates of dual human epidermal growth factor receptor 2 (HER2) blockade in a neoadjuvant setting for HER2+ breast cancer.
We searched randomized clinical trials (RCTs) using dual HER2 blockade in a neoadjuvant setting for HER2+ breast cancer in PubMed, the Cochrane Library, Embase and ClinicalTrials.gov up to July 5, 2020, and all included studies were assessed according to the Cochrane Collaboration tool for assessing the risk of bias of RCTs, and the statistical analyses were performed using STATA 14.0 software.
A total of 9 RCTs involving 2758 patients were included. Meta-analysis indicated that the pCR rates of lapatinib/pertuzumab/neratinib plus trastuzumab versus trastuzumab [relative risk (RR) = 1.31; 95% confidence interval (CI): 1.21-1.43; p < 0.001)] and lapatinib plus trastuzumab versus lapatinib (RR = 1.39; 95%CI: 1.25-1.53; p < 0.001) showed a significant statistical difference between dual HER2-blockade treatment and single-agent treatment in a neoadjuvant setting for HER2+ breast cancer. Additionally, there was no statistically significant difference in disease-free survival (HR = 0.72; 95% CI: 0.47-1.09; p = 0.123), incidence of serious adverse events (SAEs) (RR = 1.04; 95%CI: 0.81-1.33; p = 0.778) and cardiotoxicity(RR = 1.30; 95%CI: 0.81-2.08; p = 0.280), and the pCR rate was unaffected by hormone receptor status.
The pCR rate of neoadjuvant dual-target therapy for HER2+ breast cancer was significantly higher than that of single-target therapy. Furthermore, the results indicated that the safety of dual-target therapy is similar to that of single-target therapy.
研究曲妥珠单抗联合帕妥珠单抗、拉帕替尼或奈拉替尼新辅助治疗人表皮生长因子受体 2（HER2）阳性乳腺癌的病理完全缓解（pCR）率。
我们在 PubMed、Cochrane 图书馆、Embase 和 ClinicalTrials.gov 中检索了曲妥珠单抗联合帕妥珠单抗、拉帕替尼或奈拉替尼新辅助治疗 HER2 阳性乳腺癌的随机对照试验（RCT），截至 2020 年 7 月 5 日，所有纳入的研究均根据 Cochrane 协作网评估 RCT 偏倚风险的工具进行评估，统计分析采用 STATA 14.0 软件进行。
共纳入 9 项 RCT，涉及 2758 例患者。Meta 分析表明，拉帕替尼/帕妥珠单抗/奈拉替尼联合曲妥珠单抗与曲妥珠单抗相比，pCR 率[相对风险（RR）=1.31；95%置信区间（CI）：1.21-1.43；p<0.001)]和拉帕替尼联合曲妥珠单抗与拉帕替尼相比（RR=1.39；95%CI：1.25-1.53；p<0.001），在新辅助治疗 HER2 阳性乳腺癌方面，双 HER2 阻断治疗与单药治疗之间存在显著的统计学差异。此外，无病生存期（HR=0.72；95%CI：0.47-1.09；p=0.123）、严重不良事件（SAE）发生率（RR=1.04；95%CI：0.81-1.33；p=0.778）和心脏毒性（RR=1.30；95%CI：0.81-2.08；p=0.280）差异均无统计学意义，且 pCR 率不受激素受体状态的影响。
曲妥珠单抗联合帕妥珠单抗、拉帕替尼或奈拉替尼新辅助治疗 HER2 阳性乳腺癌的 pCR 率显著高于单药治疗。此外，结果表明双靶治疗的安全性与单靶治疗相似。
