Department of Medical Oncology, Batman World Hospital, Batman, Turkey.
Department of Medical Oncology, Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.
Clin Breast Cancer. 2023 Aug;23(6):567-575. doi: 10.1016/j.clbc.2023.05.015. Epub 2023 May 25.
This meta-analysis conducted a comprehensive analysis of research investigating the correlation between HER2 expression levels and treatment outcomes in early-stage triple-negative breast cancer (TNBC) patients. We systematically searched major databases for studies published up to January 01, 2023. The data from various studies examined the relationship between HER2-zero and HER2-low tumors in terms of pathological complete response (pCR) rates, disease-free survival (DFS), and overall survival (OS) outcomes. The odds ratio (OR) and 95% confidence interval (CI) by the number of events were calculated using the Mantel-Haenszel method to analyze pCR. The hazard ratio and 95% CI were calculated using the inverse variance method for DFS and OS. In all comparisons, I was 0% and no heterogeneity was detected. A total of 12 retrospective studies involving 4094 patients were included. Thirty-six percent of the patients were in the HER2-low group. All 12 studies were included in the pooled analysis for pCR, and there was no difference between HER2-zero and HER2-low (40% vs. 38%, respectively; pooled OR:1.01 95% CI 0.88-1.16; I: 0%). Four studies were included in the pooled analysis for DFS and 3 in the OS analysis. DFS and OS were significantly better in the HER2-low group (pooled hazard ratio: 0.67 for DFS, 0.64 for OS). There was no difference between HER2-low and HER2-zero in terms of pCR in early-stage TNBC. However, HER2-low was found to be associated with prolonged DFS and OS. PROSPERO REGISTRATION NUMBER: CRD42023391002.
这项荟萃分析对研究早期三阴性乳腺癌(TNBC)患者中 HER2 表达水平与治疗结果之间相关性的研究进行了全面分析。我们系统地检索了截至 2023 年 1 月 01 日发表的主要数据库中的研究。从各种研究中获得的数据,根据病理完全缓解(pCR)率、无病生存(DFS)和总生存(OS)结果,检查了 HER2-0 和 HER2-低肿瘤之间的关系。使用 Mantel-Haenszel 方法计算 OR 和 95%置信区间(CI),以分析 pCR。使用逆方差法计算 DFS 和 OS 的 HR 和 95%CI。在所有比较中,I 均为 0%,未检测到异质性。共有 12 项回顾性研究纳入了 4094 名患者。36%的患者为 HER2-低组。所有 12 项研究均纳入 pCR 的汇总分析,HER2-0 与 HER2-低之间无差异(分别为 40%和 38%;汇总 OR:1.01,95%CI 0.88-1.16;I:0%)。4 项研究纳入 DFS 的汇总分析,3 项研究纳入 OS 分析。HER2-低组 DFS 和 OS 显著更好(汇总 HR:DFS 为 0.67,OS 为 0.64)。早期 TNBC 中,HER2-低与 pCR 之间无差异。然而,HER2-低与延长 DFS 和 OS 相关。PROSPERO 注册号:CRD42023391002。