&lt;p&gt;Efficacy and safety of targeted therapy for metastatic HER2-positive breast cancer in the first-line treatment: a Bayesian network meta-analysis&lt;/p&gt;

Feng, Fubin; Zhang, Tingting; Yin, Fei; Liu, Cun; Zhuang, Jing; Qi, Ling‐Yu; Wang, Xue; Li, Jia; Wang, Lu; Tian, Jinhui; Sun, Changgang

doi:10.2147/ott.s187739

Cited by 9 publications

(10 citation statements)

References 42 publications

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“…[16][17][18] Trastuzumab, a recombinant monoclonal antibody that targets HER2, plays a fundamental role in HER2directed treatment. [19][20][21] In the neoadjuvant scenario, addition of trastuzumab has significantly increased the pCR rate and improved prognosis compared with chemotherapy alone. [22][23][24][25] Moreover, achieving pCR in HER2-positive disease significantly correlates with better survival in terms of event-free survival (EFS) and overall survival.…”

Section: Introductionmentioning

confidence: 99%

“…This issue will be increasingly critical as the efficacy of trastuzumab is fundamental and irreplaceable despite novel anti-HER2 agents. [19][20][21] Preclinical evidence suggests a key role of immune mechanisms in modulation of the effect of trastuzumab. [27][28][29] The antitumor immune response depends on the infiltration of anti-or proinflammatory immune cells in the tumor microenvironment.…”

Section: Introductionmentioning

confidence: 99%

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<p>Therapeutic Effect of Trastuzumab in Neoadjuvant-Treated HER2-Positive Breast Cancer with Low Infiltrating Level of Tumor-Infiltrating Lymphocytes</p>

Liu¹,

Mou²,

Zeng³

et al. 2020

CMAR

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The aim of the present study was to investigate the effect of trastuzumab on the pathological complete response (pCR) rate and event-free survival (EFS) in neoadjuvant-treated HER2-positive breast cancer with a low infiltrating level of tumor-infiltrating lymphocytes (TILs). Patients and Methods: The infiltrating level of TILs was evaluated in hematoxylin and eosin-stained slides from diagnostic needle biopsies, and a low infiltrating level of TILs was defined as TILs < 10%. Data of 179 HER2-positive patients with a low infiltrating level of TILs were retrospectively reviewed and compared according to whether trastuzumab was administered or not. The associations of clinicopathological characteristics with pCR or EFS were assessed in univariate and multivariate analyses. EFS was estimated by the Kaplan-Meier method and compared by the log rank test. Results: Of 179 patients, the overall pCR rate was 20.1%, and 74 patients (41.3%) received trastuzumab. Patients treated with trastuzumab showed a pCR rate of 20.3% compared with 20.0% for those without trastuzumab (P = 0.965). Trastuzumab administration was not associated with pCR in univariate (P = 0.965) and multivariate (P = 0.994) analyses. Negative status of hormone receptor (HR) (P < 0.001) and histological grade 3 (P = 0.007) were independent predictors for pCR in multivariate analyses. Trastuzumab usage had no significant impact on EFS in univariate (P = 0.916) and multivariate (P = 0.431) analyses, and pCR was the only independent predictor for favorable EFS (P = 0.012) in multivariate analyses. Conclusion:In neoadjuvant-treated HER2-positive breast cancer with a low infiltrating level of TILs, additional trastuzumab had no significant influence on the pCR rate and EFS. HR-negative status and histological grade 3 were independently associated with higher pCR rates, and pCR was the only independent predictor for improved survival. Our findings may help identify patients who are resistant to trastuzumab, thereby guiding the de-escalating choice of anti-HER2 therapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Therapeutic Effect of Trastuzumab in Neoadjuvant-Treated HER2-Positive Breast Cancer with Low Infiltrating Level of Tumor-Infiltrating Lymphocytes</p>

Liu¹,

Mou²,

Zeng³

et al. 2020

CMAR

Self Cite

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“…In the absence of direct comparative trials, network metaanalyses (NMAs) are a valid approach to evaluate comparative efficacy [16]. Several NMAs have already been conducted to assess therapies in patients with HER2+ MBC, but most have included data from patients receiving first-line therapy [17][18][19][20][21][22]. More recently, a comprehensive NMA was conducted to compare T-DM1 with other approved therapies for patients with HER2+ MBC who had received one or more prior anti-HER2 directed therapies in the metastatic setting [23].…”

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confidence: 99%

Efficacy of Tucatinib for HER2-Positive Metastatic Breast Cancer After HER2-Targeted Therapy: A Network Meta-Analysis

DeBusk

Abeysinghe²,

Vickers³

et al. 2021

Future Oncol.

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Aim: A systematic literature review and network meta-analysis of randomized controlled trials in patients receiving therapy for HER2+ unresectable/metastatic breast cancer after ≥1 HER2-directed therapy was conducted to compare progression-free survival (PFS) and overall survival (OS). Methods: Hazard ratios (HRs) and relative differences from fractional polynomials (FPs) for PFS and OS were assessed by Bayesian network meta-analyses. Results: For PFS, surface under the cumulative rankogram (SUCRA) ranked tucatinib plus trastuzumab with capecitabine as highest in both HR and FP analyses, followed by T-DM1 monotherapy and neratinib plus capecitabine. For OS, SUCRA ranked tucatinib plus trastuzumab with capecitabine as highest in both HR and FP analyses, followed by pertuzumab plus trastuzumab with capecitabine and T-DM1 monotherapy, with similar scores. Conclusion: Tucatinib plus trastuzumab with capecitabine, and T-DM1 monotherapy, consistently showed improved PFS and OS versus lapatinib/trastuzumab plus capecitabine and non-targeted treatments.

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“…Tumors characterized by the presence of the HER2 protein are found in 25–30% of all breast cancers . Patients with HER2‐positive disease are less responsive to traditional therapies and have a worse prognosis . Substantial progress was recently made in the treatment of HER2‐positive disease with the development of effective HER2‐targeted therapies .…”

mentioning

confidence: 99%

“…Patients with HER2‐positive disease are less responsive to traditional therapies and have a worse prognosis . Substantial progress was recently made in the treatment of HER2‐positive disease with the development of effective HER2‐targeted therapies . However, the choice of treatment of HER2‐negative disease is challenging because no standard up‐front therapy exists for this population.…”

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confidence: 99%

Comparative Effectiveness of Taxane‐Containing Regimens for Treatment of HER2‐Negative Metastatic Breast Cancer: A Network Meta‐analysis

et al. 2019

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STUDY OBJECTIVES To compare the effectiveness of different taxane-containing regimens and to identify the best strategy for the treatment of human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). DESIGN Network meta-analysis of 20 randomized controlled trials (RCTs). PATIENTS A total of 6577 patients with HER2-negative MBC who received treatment (20 different regimens) with taxanes (paclitaxel [4267 patients] or docetaxel [2310 patients]). MEASUREMENTS AND MAIN RESULTS The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched (through March 2019) for RCTs that evaluated any taxane-containing regimens for the treatment of HER2-negative MBC. A network meta-analysis in a Bayesian framework was performed using the random-effects model. We compared the surface under the cumulative ranking (SUCRA) curve for each regimen. Overall, paclitaxel-based combinations were superior to paclitaxel alone in objective response rate (ORR) (odds ratio 1.60, 95% credible interval [CrI] 1.15-2.16) and overall survival (OS) (hazard ratio 1.08, 95% CrI 1.01-1.15). Docetaxel-based combinations were also superior to paclitaxel alone in ORR. Among the paclitaxel-based regimens, based on the results of SUCRA, paclitaxel + bevacizumab + capecitabine was likely to be the most efficacious in improving ORR, OS, and progression-free survival (PFS), whereas paclitaxel + gemcitabine was likely to be the most efficacious in 1-year OS rate. Among the docetaxel-based a These authors contributed equally to this work.regimens, based on the results of SUCRA, docetaxel + gemcitabine was likely to be the most efficacious in improving PFS and OS. CONCLUSION These findings demonstrated that paclitaxel-based combinations can provide significant improvement in ORR and OS compared with paclitaxel alone. The regimens of paclitaxel + bevacizumab + capecitabine, docetaxel + gemcitabine, and paclitaxel + gemcitabine may be superior to other regimens for the treatment of HER2-negative MBC. KEY WORDS taxanes, paclitaxel, docetaxel, metastatic breast cancer, network meta-analysis.

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<p>Efficacy and safety of targeted therapy for metastatic HER2-positive breast cancer in the first-line treatment: a Bayesian network meta-analysis</p>

Cited by 9 publications

References 42 publications

<p>Therapeutic Effect of Trastuzumab in Neoadjuvant-Treated HER2-Positive Breast Cancer with Low Infiltrating Level of Tumor-Infiltrating Lymphocytes</p>

<p>Therapeutic Effect of Trastuzumab in Neoadjuvant-Treated HER2-Positive Breast Cancer with Low Infiltrating Level of Tumor-Infiltrating Lymphocytes</p>

Efficacy of Tucatinib for HER2-Positive Metastatic Breast Cancer After HER2-Targeted Therapy: A Network Meta-Analysis

Comparative Effectiveness of Taxane‐Containing Regimens for Treatment of HER2‐Negative Metastatic Breast Cancer: A Network Meta‐analysis

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