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Zhang X, Leng J, Zhou Y, et al. Efficacy and Safety of Anti-HER2 Agents in Combination With Chemotherapy for Metastatic HER2-Positive Breast Cancer Patient: A Network Meta-Analysis. Front Oncol. 2021;11:731210doi: 10.3389/fonc.2021.731210.
Zhang, X., Leng, J., Zhou, Y., Mao, F., Lin, Y., Shen, S., & Sun, Q. (2021). Efficacy and Safety of Anti-HER2 Agents in Combination With Chemotherapy for Metastatic HER2-Positive Breast Cancer Patient: A Network Meta-Analysis. Frontiers in oncology, 11731210. https://doi.org/10.3389/fonc.2021.731210
Zhang, Xiaohui, et al. "Efficacy and Safety of Anti-HER2 Agents in Combination With Chemotherapy for Metastatic HER2-Positive Breast Cancer Patient: A Network Meta-Analysis." Frontiers in oncology vol. 11 (2021): 731210. doi: https://doi.org/10.3389/fonc.2021.731210
Zhang X, Leng J, Zhou Y, Mao F, Lin Y, Shen S, Sun Q. Efficacy and Safety of Anti-HER2 Agents in Combination With Chemotherapy for Metastatic HER2-Positive Breast Cancer Patient: A Network Meta-Analysis. Front Oncol. 2021 Aug 19;11:731210. doi: 10.3389/fonc.2021.731210. eCollection 2021. PMID: 34490125; PMCID: PMC8416996.
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Front Oncol. 2021 Aug 19;11:731210. doi: 10.3389/fonc.2021.731210. eCollection 2021.

Efficacy and Safety of Anti-HER2 Agents in Combination With Chemotherapy for Metastatic HER2-Positive Breast Cancer Patient: A Network Meta-Analysis.

Frontiers in oncology

Xiaohui Zhang, Junsheng Leng, Yidong Zhou, Feng Mao, Yan Lin, Songjie Shen, Qiang Sun

Affiliations

  1. Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China.
  2. Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China.

PMID: 34490125 PMCID: PMC8416996 DOI: 10.3389/fonc.2021.731210

Abstract

BACKGROUND: The presence of anti-HER2 agents, such as trastuzumab, pertuzumab, and trastuzumab emtansine (T-DM1), significantly improved the prognosis of metastatic HER2-positive (HER2+) breast cancers (BC). However, drug resistance and disease progression are still common. In order to further improve the treatment efficacy, new clinical trials about anti-HER2 agents in combination with chemotherapy are growing rapidly. We conducted the network meta-analysis to synthesize evidences of clinical trials to identify the best therapy for metastatic HER2+ BC.

METHODS: A systematic search of randomized controlled trials regarding anti-HER2 agents in combination with chemotherapy for advanced or metastatic breast cancers up to May 2020 was conducted in Embase, PubMed, and the Cochrane Library. The primary outcome was progression-free survival (PFS). The secondary outcomes were overall survival (OS), objective response rate (ORR), and safety. Bayesian network meta-analysis was conducted to synthesize the results and rank the therapies.

RESULTS: Twenty-six studies, including 16 studies for first-line treatments and 10 studies for second- or later-line treatments were included in the network meta-analysis. For first-line studies, the THP (taxanes + trastuzumab + pertuzumab) regimen exhibited the highest probability to be the optimal treatment in all efficacy outcomes and moderate safety. For second- or later-line studies, the T-DM1 and XHTuC (capecitabine + trastuzumab + tucatinib) regimens ranked top two in all efficacy outcomes according to the surface under the cumulative ranking (SUCRA) results. T-DM1 ranked first in PFS and OS whereas XHTuC ranked first in ORR. The safety outcomes of T-DM1 and XHTuC were acceptable.

CONCLUSIONS: THP was still the optimal first-line treatment for metastatic HER2+ BC. T-DM1 and XHTuC were recommended for second-line treatments.

SYSTEMATIC REVIEW REGISTRATION: INPLASY.com, identifier (INPLASY202090086).

Copyright © 2021 Zhang, Leng, Zhou, Mao, Lin, Shen and Sun.

Keywords: anti-HER2 agents; efficacy; metastatic HER2-positive breast cancer; network meta-analysis; safety

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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