机构：[1]Department of Central Laboratory, Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, China北京大学深圳医院深圳市康宁医院深圳医学信息中心[2]Department of Oncology,The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China[3]Department of Surgery,The Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China[4]Department of General Surgery,The First Affiliated Hospital of Xiamen University, Xiamen, China[5]Department of Biostatistics, Southern Medical University, Guangzhou, China[6]Department of Surgery, TheThird Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China[7]School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
This network meta-analysis addresses the need for evidence-based best-practice treatment regimens for HER2-positive breast cancer. We compared the relative efficacy and tolerability of currently available HER2-positive neoadjuvant immunotherapy regimens based on systematic searches of available randomized controlled trials (RCTs) data. Based on intention-to-treat principle, pathological complete response (pCR), overall serious adverse events (SAEs), and breast-conserving surgery (BCS) rate were analyzed using random-effect, Bayesian network meta-analysis, and standard pairwise meta-analysis. 16 RCTs (3868 patients) were included. Analyzed treatment regimens were as follows: chemotherapy+trastuzumab+pertuzumab (CTP), trastuzumab emtansine+pertuzumab (MP), chemotherapy+trastuzumab (CT), chemotherapy+pertuzumab (CP), trastuzumab+pertuzumab (TP), chemotherapy+trastuzumab+lapatinib (CTL), and chemotherapy+lapatinib (CL), and chemotherapy (C) alone. We found that, for the chance of achieving pCR, CTP was ranked first (SUCRA: 97%), followed by CTL, MP, and CT (SUCRA: 80%, 75%, and 55%, resp.). MP provided the safest regimen (SUCRA: 97%), then TP, C, and TPC (SUCRA: 82%, 76%, and 47%, resp.). CTL proved the most toxic therapy (SUCRA: 7%). No significant difference between neoadjuvant regimens was identified for BCS. Hormone receptor status did not impact ORs for pCR in any regimen. In conclusion, our findings support CTP as the optimum neoadjuvant regimen for HER2-positive breast cancer, with the best pCR and acceptable toxicity compared with CT. MP provides a therapeutic option for patients with poor performance status.
基金：
This research was funded by the National Natural Science Foundation of China (no. 31871244/81673270/81603526) and Guangdong Province Medical Scientific Research Foundation (no. A2014364).
第一作者机构：[1]Department of Central Laboratory, Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, China[2]Department of Oncology,The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Central Laboratory, Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, China[2]Department of Oncology,The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
推荐引用方式(GB/T 7714)：
Di Wu,Tiejun Chen,Han Jiang,et al.Comparative Efficacy and Tolerability of Neoadjuvant Immunotherapy Regimens for Patients with HER2-Positive Breast Cancer: A Network Meta-Analysis.[J].JOURNAL OF ONCOLOGY.2019,2019:doi:10.1155/2019/3406972.
APA：
Di Wu,Tiejun Chen,Han Jiang,Chongyang Duan,Xinjian Zhang...&Fenfang Wu.(2019).Comparative Efficacy and Tolerability of Neoadjuvant Immunotherapy Regimens for Patients with HER2-Positive Breast Cancer: A Network Meta-Analysis..JOURNAL OF ONCOLOGY,2019,
MLA：
Di Wu,et al."Comparative Efficacy and Tolerability of Neoadjuvant Immunotherapy Regimens for Patients with HER2-Positive Breast Cancer: A Network Meta-Analysis.".JOURNAL OF ONCOLOGY 2019.(2019)
