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HER2 低表达状态对三阴性乳腺癌病理完全缓解和生存的影响:系统评价和荟萃分析。

The Effect of HER2-Low Status on Pathological Complete Response and Survival in Triple-Negative Breast Cancer: A Systemic Review and Meta-Analysis.

机构信息

Department of Medical Oncology, Batman World Hospital, Batman, Turkey.

Department of Medical Oncology, Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.

出版信息

Clin Breast Cancer. 2023 Aug;23(6):567-575. doi: 10.1016/j.clbc.2023.05.015. Epub 2023 May 25.

Abstract

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.

摘要

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。

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