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The Efficacy and Safety of Additional Anti-HER2-Targeting Drugs in the Treatment of HER2-Positive Advanced Breast Cancer: A Meta-Analysis

[ Vol. 21 , Issue. 14 ]

Author(s):

Nannan Du, Bangsheng Chen, Zefeng Shen, Bin Zhou, Xiaojun Fu, Danyi Mao, Feiyan Mao, Derry M. Ng, Parikshit A. Khadaroo and Lei Yang*   Pages 1931 - 1940 ( 10 )

Abstract:


Background: HER2-positive breast cancer patients account for one-fifth of the total breast cancer population. Besides, more and more anti-HER2-targeting drugs have appeared clinically.

Objective: This study aimed to analyze the efficacy and safety of additional anti-HER2 (human epidermal growth factor receptor 2)- targeting drugs in the treatment of HER2-positive advanced breast cancers.

Methods: The following databases were searched for published articles containing data on the efficacy and safety of additional anti-HER2- targeting drugs in HER2-positive advanced breast cancer from the time of their inception until December 2019: PubMed, Web of Science, EBSCO, and Cochrane library. The primary outcomes were progression-free survival (PFS) and overall survival(OS).

Results: The additional anti-HER2-targeting drugs significantly improved the PFS (HR: 0.66, p<0.001) and OS (HR: 0.77, p<0.001) of HER2-positive advanced breast cancer patients. Regarding drug types, lapatinib was the most effective (HR: 0.53, 95% Cl: 0.39-0.67, p<0.001), followed by pertuzumab (HR: 0.72, 95% Cl: 0.55-0.89, p=0.001). Trastuzumab was the least beneficial (HR: 0.87, 95% Cl: 0.31- 1.44, p=0.594). Concerning treatment regimen, first-line treatment (HR: 0.67, 95% Cl: 0.52-0.82, p<0.001) was more effective than nonfirst-line treatment (HR: 0.82, 95% Cl: 0.71-0.94, p=0.004). The main adverse events (AEs) observed were diarrhea and decreased ejection fraction.

Conclusion: Additional anti-HER2-targeting drugs can improve long-term prognosis in HER2-positive advanced breast cancers. Besides, they are associated with fewer AEs and tolerable. Lapatinib is the most effective drug, followed by pertuzumab, whereas trastuzumab is the least effective. Concerning treatment, we recommend the use of anti-HER2-targeting drugs in first-line therapy of HER2-positive advanced breast cancers.

Keywords:

Human Epidermal growth Factor Receptor 2 (HER2), breast cancer, efficacy, safety, meta-analysis.

Affiliation:

The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, Emergency Medical Center, Ningbo Yinzhou No 2 Hospital, Ningbo, Zhejiang, Department of General Surgery, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, Medical College of Ningbo University, Ningbo, Zhejiang, Monash University School of Medicine, Nursing and Health Sciences, Melbourne, Emergency Medical Center, Ningbo Yinzhou No 2 Hospital, Ningbo, Zhejiang



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