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使用曲妥珠单抗的Her2阳性早期乳腺癌女性的健康相关生活质量:一项系统评价和荟萃分析。

Health-related quality of life in Her2-positive early breast cancer woman using trastuzumab: A systematic review and meta-analysis.

作者信息

Khoirunnisa Sudewi Mukaromah, Suryanegara Fithria Dyah Ayu, Setiawan Didik, Postma Maarten Jacobus

机构信息

Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.

Department of Pharmacy, Institut Teknologi Sumatera, Lampung Selatan, Indonesia.

出版信息

Front Pharmacol. 2023 Apr 14;14:1090326. doi: 10.3389/fphar.2023.1090326. eCollection 2023.

Abstract

Despite the benefits of trastuzumab in many trials, evidence of its impact on health-related quality of life (HRQoL) in early treatment has not been summarized. This study explored the effects of trastuzumab treatment on HRQoL, including pooled meta-analysis, in an effort to provide an integrated assessment of HRQoL for Her2-positive early breast cancer patients. A comprehensive literature review to February 2023 using three databases, focusing on treatment using trastuzumab during the early stage, was performed. The mean changes from baseline during and after treatment were extracted from the included randomized control trials (RCTs) papers and total HRQoL scores were obtained from cross-sectional studies included. Mean difference (MD) and 95% confidence intervals were assessed by a random effect or fixed effect model based on heterogeneity (I). A total of ten studies were identified and reviewed, consisting of seven RCTs and three cross-sectional studies. The pooled analysis of the mean change from baseline during treatment resulted in an MD of 1.92 (95% CI = 1.59 to 2.25, < 0.05, I = 0%), favoring the trastuzumab group. A non-significant result of the mean change from baseline after treatment appeared in the analysis of 12-month follow-up. In the cross-sectional studies, pooled analyses of HRQoL showed that trastuzumab meaningfully demonstrated an improved HRQoL profile (MD = 9.29, 95% CI = 1.31 to 17.27, = 0.02, I = 0%). Trastuzumab as a targeted therapy resulted in a favorable effect on HRQoL in the early stages of Her2-positive breast cancer. The findings of significant improvements in patients' HRQoL and less clinically meaningful deterioration in side effects of trastuzumab-containing regimen during treatment were supported by prolonged survival.

摘要

尽管在许多试验中曲妥珠单抗显示出诸多益处,但关于其在早期治疗中对健康相关生活质量(HRQoL)影响的证据尚未得到总结。本研究探讨了曲妥珠单抗治疗对HRQoL的影响,包括汇总荟萃分析,旨在为Her2阳性早期乳腺癌患者的HRQoL提供综合评估。我们使用三个数据库对截至2023年2月的文献进行了全面回顾,重点关注早期使用曲妥珠单抗的治疗情况。从纳入的随机对照试验(RCT)论文中提取治疗期间及治疗后相对于基线的平均变化,并从纳入的横断面研究中获取总的HRQoL评分。基于异质性(I),采用随机效应或固定效应模型评估平均差异(MD)和95%置信区间。共识别并回顾了10项研究,包括7项RCT和3项横断面研究。治疗期间相对于基线平均变化的汇总分析得出MD为1.92(95%CI = 1.59至2.25,P < 0.05,I = 0%),支持曲妥珠单抗组。在12个月随访分析中,治疗后相对于基线的平均变化结果无统计学意义。在横断面研究中,HRQoL的汇总分析表明曲妥珠单抗显著改善了HRQoL状况(MD = 9.29,95%CI = 1.31至17.27,P = 0.02,I = 0%)。曲妥珠单抗作为一种靶向治疗药物,在Her2阳性乳腺癌早期对HRQoL产生了有益影响。患者HRQoL显著改善以及含曲妥珠单抗方案治疗期间副作用在临床上有意义的恶化较少这一结果,得到了生存期延长的支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1043/10140570/2fc1ea9a6034/fphar-14-1090326-g001.jpg

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