Li Lixi, Zhang Di, Wu Yun, Wang Jiayu, Ma Fei
Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Pan jia yuan nan Road 17, Beijing 100021, China.
Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Pan jia yuan nan Road 17, Beijing 100021, China; Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Biochim Biophys Acta Rev Cancer. 2023 Nov;1878(6):188969. doi: 10.1016/j.bbcan.2023.188969. Epub 2023 Aug 26.
This study aimed to explore the efficacy and safety of trastuzumab plus tyrosine kinase inhibitors (TKIs) compared with those of trastuzumab monotherapy in patients with human epidermal growth factor receptor (HER2)-positive breast cancer.
The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for relevant articles from inception until September 2022. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Subgroup analyses were performed based on disease status, TKI type, and hormone receptor status.
Sixteen studies were included in the current analysis. Trastuzumab plus TKI significantly improved OS and PFS compared to trastuzumab monotherapy. In the neoadjuvant setting, trastuzumab plus TKI significantly increased the pathologic complete response (pCR) rate compared to trastuzumab monotherapy. Moreover, a higher objective response rate (ORR) was observed with trastuzumab plus TKI. Patients who received the combination therapy had a higher incidence of discontinuation, all-grade diarrhea, and grade ≥ 3 diarrhea.
Trastuzumab plus TKI was better than trastuzumab monotherapy for treating different stages of HER2-positive breast cancer. The safety of trastuzumab plus TKI anti-HER2 therapy was controllable. The different efficacies of TKIs combined with trastuzumab may be related to the mechanism of action of the different TKIs, needing further investigations.
本研究旨在探讨曲妥珠单抗联合酪氨酸激酶抑制剂（TKIs）与曲妥珠单抗单药治疗相比，在人表皮生长因子受体（HER2）阳性乳腺癌患者中的疗效和安全性。
系统检索了PubMed、Embase、Cochrane和Web of Science数据库，从建库至2022年9月的相关文章。主要结局为总生存期（OS）和无进展生存期（PFS）。根据疾病状态、TKI类型和激素受体状态进行亚组分析。
本分析纳入了16项研究。与曲妥珠单抗单药治疗相比，曲妥珠单抗联合TKI显著改善了OS和PFS。在新辅助治疗中，与曲妥珠单抗单药治疗相比，曲妥珠单抗联合TKI显著提高了病理完全缓解（pCR）率。此外，曲妥珠单抗联合TKI观察到更高的客观缓解率（ORR）。接受联合治疗的患者停药、所有级别腹泻和≥3级腹泻的发生率更高。
曲妥珠单抗联合TKI在治疗不同分期的HER2阳性乳腺癌方面优于曲妥珠单抗单药治疗。曲妥珠单抗联合TKI抗HER2治疗的安全性可控。TKIs与曲妥珠单抗联合使用的不同疗效可能与不同TKIs的作用机制有关，需要进一步研究。
