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• W3011912378 abstract "Purpose . Although trastuzumab is the standard of care for patients with human epidermal growth factor receptor 2 (HER2)- positive early breast cancer (EBC), drug resistance and disease relapse occur. Therefore, we performed a meta-analysis to assess the efficacy and safety of trastuzumab-containing dual anti-HER2 therapy compared to trastuzumab alone. Methods . A systematic search was performed to identify eligible randomized controlled trials (RCTs). Main outcomes including event-free survival/invasive disease-free survival (EFS/iDFS), overall survival (OS), and safety were considered. Results . Ten RCTs were included (15,284 patients). Significant improvements were observed in both EFS/iDFS (HR 0.86, <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M1><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.0003</mml:mn></mml:mrow></mml:math>) and OS (HR 0.86, <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M2><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.02</mml:mn></mml:mrow></mml:math>) with trastuzumab-based dual anti-HER2 therapy, especially in adjuvant treatment, while in the neoadjuvant setting, dual-targeted therapy also achieved a substantial pathological complete response (pCR) benefit (HR 1.34, <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M3><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.0002</mml:mn></mml:mrow></mml:math>). Subgroup analysis revealed that the EFS/iDFS benefit was slightly higher with trastuzumab plus pertuzumab or plus neratinib than trastuzumab plus lapatinib, while OS benefit was significant with trastuzumab plus lapatinib, but there were no subgroup differences (interaction test, <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M4><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.80</mml:mn></mml:mrow></mml:math> and 0.24, resp.). In addition, EFS/iDFS benefit was unrelated to hormone receptor status but pronounced in the lymph node-positive (LN+) subgroup, which should be interpreted cautiously for lacking interaction (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M5><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.18</mml:mn></mml:mrow></mml:math>). Besides, patients receiving dual therapy, especially with the lapatinib-containing regimen, experienced more toxicity, but no increase in cardiotoxicity. Conclusions . Despite being associated with more toxicity, trastuzumab-containing dual anti-HER2 therapy is superior to trastuzumab single agent for HER2-positive EBC independent of hormone receptor status. The correlation between survival and LN status needs further verification. Trastuzumab plus pertuzumab or plus neratinib is the preferred regimen with substantial efficacy and lower toxicity." @default.
• W3011912378 created "2020-03-23" @default.
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• W3011912378 date "2020-03-16" @default.
• W3011912378 modified "2023-10-14" @default.
• W3011912378 title "Dual HER2 Blockade versus a Single Agent in Trastuzumab-Containing Regimens for HER2-Positive Early Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials" @default.
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• W3011912378 doi "https://doi.org/10.1155/2020/5169278" @default.
• W3011912378 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/7102417" @default.
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• W3011912378 hasPublicationYear "2020" @default.
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