Ndirangu Kerigo, Goldgrub Rachel, Tongbram Vanita, Antony Rajee, Lalayan Bagrat, O'Shaughnessy Joyce, Schellhorn Sarah E
Eisai, 200 Metro Blvd, Nutley, NJ 07110, USA.
ICON plc, 688 W Hastings St, Vancouver, BC V6B 1P1, Canada.
J Comp Eff Res. 2024 May 29;13(6):e230153. doi: 10.57264/cer-2023-0153.
This systematic literature review aims to summarize the efficacy/effectiveness of treatments, including eribulin (ERI)-based and anti-human epidermal growth factor receptor 2 (HER2) treatments in advanced/metastatic HER2+ breast cancer. Three databases from 2016 to September 2021 were searched for clinical trials and observational studies in patients receiving first-line (1L) standard of care (SOC), second-line (2L) SOC or third-line or subsequent lines (3L+). 2692 citations were screened, and 38 studies were included. Eleven studies were randomized-controlled trials (RCTs; 5 in 1L, 6 in 3L+), 6 were single-arm trials (5 in 1L, 1 in 3L+) and 21 were observational studies (13 in 1L, 6 in 2L, 4 in 3L+ [note that studies with subgroups for 1L, 2L, 3L+ are double-counted]). Longer overall survival (OS) was associated with 1L and 2L treatment, and for 3L+ studies that included ERI, ERI or trastuzumab (Tmab) + ERI led to longer OS than treatments of physician's choice (median OS of 11, 10 and 8.9 months, respectively). Progression-free survival was 9 months in Tmab + pertuzumab (Pmab) + ERI, 4 months in Tmab + ERI and 3.3 months in ERI. Available treatments provide a wide range of efficacy. However, later lines lack standardization and conclusions on comparative effectiveness are limited by differing trial designs. Thus, the chance of prolonged survival with new agents warrants further research.
本系统文献综述旨在总结治疗方法的疗效,包括以艾瑞布林(ERI)为基础的治疗以及抗人表皮生长因子受体2(HER2)治疗在晚期/转移性HER2阳性乳腺癌中的疗效。检索了2016年至2021年9月期间的三个数据库,以查找接受一线(1L)标准治疗(SOC)、二线(2L)SOC或三线及后续治疗(3L+)的患者的临床试验和观察性研究。共筛选出2692篇文献,纳入38项研究。其中11项为随机对照试验(RCT;5项在1L,6项在3L+),6项为单臂试验(5项在1L,1项在3L+),21项为观察性研究(13项在1L,6项在2L,4项在3L+[注意,包含1L、2L、3L+亚组的研究被重复计算])。1L和2L治疗与更长的总生存期(OS)相关,对于包含ERI的3L+研究,ERI或曲妥珠单抗(Tmab)+ERI导致的OS长于医生选择的治疗(中位OS分别为11、10和8.9个月)。曲妥珠单抗(Tmab)+帕妥珠单抗(Pmab)+ERI的无进展生存期为9个月,Tmab+ERI为4个月,ERI为3.3个月。现有治疗方法具有广泛的疗效。然而,后续治疗缺乏标准化,不同试验设计限制了比较疗效的结论。因此,新药物延长生存期的可能性值得进一步研究。
Breast Cancer (Auckl). 2024-2-25