Umemneku-Chikere Chinyereugo M, Ayodele Olubukola, Soares Marta, Khan Sam, Abrams Keith, Owen Rhiannon, Bujkiewicz Sylwia
Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
University Hospital Leicester National Health Service (NHS) Trust, Leicester Royal Infirmary, Leicester, United Kingdom.
Front Oncol. 2022 Aug 18;12:943154. doi: 10.3389/fonc.2022.943154. eCollection 2022.
Breast cancer is the fifth leading cause of cancer-related deaths worldwide. The randomized controlled trials (RCTs) of targeted therapies in human epidermal receptor 2 (HER2)-positive advanced breast cancer (ABC) have provided an evidence base for regulatory and reimbursement agencies to appraise the use of cancer therapies in clinical practice. However, a subset of these patients harbor additional biomarkers, for example, a positive hormone receptor status that may be more amenable to therapy and improve overall survival (OS). This review seeks to explore the reporting of evidence for treatment effects by the hormone receptor status using the RCT evidence of targeted therapies for HER2-positive ABC patients. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed to identify published RCTs. Extracted data were synthesized using network meta-analysis to obtain the relative effects of HER2-positive-targeted therapies. We identified a gap in the reporting of the effectiveness of therapies by the hormone receptor status as only 15 out of 42 identified RCTs reported hormone receptor subgroup analyses; the majority of which reported progression-free survival but not OS or the overall response rate. In conclusion, we recommend that future trials in ABC should report the effect of cancer therapies in hormone receptor subgroups for all outcomes.
乳腺癌是全球癌症相关死亡的第五大主要原因。针对人表皮生长因子受体2（HER2）阳性晚期乳腺癌（ABC）的靶向治疗随机对照试验（RCT）为监管机构和报销机构评估癌症治疗在临床实践中的使用提供了证据基础。然而，这些患者中有一部分还存在其他生物标志物，例如，激素受体状态呈阳性，这可能对治疗更敏感并改善总生存期（OS）。本综述旨在利用HER2阳性ABC患者靶向治疗的RCT证据，探讨按激素受体状态报告治疗效果的证据。遵循系统评价和Meta分析的首选报告项目（PRISMA）指南来识别已发表的RCT。使用网络Meta分析对提取的数据进行综合分析，以获得HER2阳性靶向治疗的相对疗效。我们发现按激素受体状态报告治疗效果方面存在差距，因为在42项已识别的RCT中，只有15项报告了激素受体亚组分析；其中大多数报告了无进展生存期，但未报告总生存期或总缓解率。总之，我们建议未来ABC试验应报告癌症治疗在激素受体亚组中对所有结局的影响。
