Xia Lin-Yu, Cao Xu-Chen, Hu Qing-Lin, Xu Wei-Yun
Department of Thyroid and Breast Surgery, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
Front Oncol. 2024 Aug 29;14:1413674. doi: 10.3389/fonc.2024.1413674. eCollection 2024.
The combination of CDK4/6 inhibitors (CDK4/6i) and endocrine therapy (ET) is currently the standard first-line treatment for patients with metastatic hormone receptor positive (HR+), and HER2-negative (HER2-) breast cancer. However, the impact of HER2 status on the prognosis of patients receiving CDK4/6i and ET remains unclear. The meta-analysis was conducted to evaluate different outcomes between HER2-low and HER2-zero patients in advanced HR+ breast cancer receiving CDK4/6i and ET.
A systematic search was performed in PubMed and EMBASE databases for relevant published literature. Objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) were pooled by fixed or random effects models.
Overall, 12 studies with 3567 patients were eligible for analysis. The pooled analysis suggested that no significant differences were observed in terms of ORR and OS between HER2-low and HER2-zero patients who underwent CDK4/6i and ET. Similarly, no significant difference in PFS was found between HER2-low and HER2-zero patients who underwent post-line CDK4/6i and ET or first-line Palbociclib and ET. However, in patients who received mixed-line (not a single treatment line) or first-line CDK4/6i and ET, the PFS was significantly shorter in the HER2-low subgroup than in the HER2-zero subgroup (mixed-line: HR = 1.36; 95% CI = 1.11-1.65; = 0.002; first-line: HR = 1.14; 95% CI = 1.01-1.28; = 0.04). A similar phenomenon was observed in patients who received mixed-line or post-line Palbociclib and ET (mixed-line: HR = 1.60; 95% CI = 1.09-2.34; = 0.02; post-line: HR = 1.43; 95% CI = 1.03-2.00; = 0.03).
These results indicated that HER2-low status did not have a significant association with ORR and OS, but it may have a worse impact on PFS in patients who received mixed-line or first-line CDK4/6i and ET, as well as mixed-line or post-line palbociclib plus ET.
细胞周期蛋白依赖性激酶4/6抑制剂（CDK4/6i）与内分泌治疗（ET）联合使用目前是激素受体阳性（HR+）、人表皮生长因子受体2阴性（HER2-）转移性乳腺癌患者的标准一线治疗方案。然而，HER2状态对接受CDK4/6i和ET治疗患者预后的影响仍不明确。本荟萃分析旨在评估接受CDK4/6i和ET治疗的晚期HR+乳腺癌患者中HER2低表达和HER2零表达患者的不同预后。
在PubMed和EMBASE数据库中进行系统检索，以查找相关的已发表文献。客观缓解率（ORR）、总生存期（OS）和无进展生存期（PFS）通过固定效应或随机效应模型进行汇总。
总体而言，12项研究共3567例患者符合分析条件。汇总分析表明，接受CDK4/6i和ET治疗的HER2低表达和HER2零表达患者在ORR和OS方面未观察到显著差异。同样，接受二线CDK4/6i和ET或一线哌柏西利和ET治疗的HER2低表达和HER2零表达患者在PFS方面也未发现显著差异。然而，在接受多线（非单一治疗线）或一线CDK4/6i和ET治疗的患者中，HER2低表达亚组的PFS显著短于HER2零表达亚组（多线：风险比[HR]=1.3
