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A network meta-analysis on the efficacy of HER2-targeted agents in combination with taxane-containing regimens for treatment of HER2-positive metastatic breast cancer.

Abstract

PURPOSE

We performed a network meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of HER2-targeted agents in combination with taxanes and to identify the best strategy for HER2+ metastatic breast cancer (MBC).

METHODS

Pubmed, Embase, the Cochrane Library, and ClinicalTrials.gov were searched for randomized controlled trials that evaluated any taxanes+HER2-targeted agents in the treatment of HER2+ MBC. The primary outcome was overall survival (OS). The secondary outcomes included overall response rate (ORR) and progression-free survival (PFS).

RESULTS

A total of 13 RCTs were eligible, involving 4941 patients and 10 regimens. The result showed that single-HER2-targeted agent+a taxane did improve the effect on ORR and PFS than taxane alone, but only trastuzumab+a taxane had a significant improvement in OS outcomes. Single-HER2-targeted agent (trastuzumab) combined with taxane-based doublets (taxane+carboplatin/capecitabine/doxorubicin/bevacizumab) showed no further benefit than trastuzumab+a taxane. Doublet-HER2-targeted agents combined with a taxane(trastuzumab+pertuzumab+a taxane) showed further improvement in ORR, PFS, and all OS outcomes than single-HER2-targeted agent+a taxane. Ranking analysis based on their P-scores suggested that trastuzumab+pertuzumab+a taxane was the best combination treatment for all the efficacy outcomes.

CONCLUSIONS

These findings demonstrate that combining two HER2-targeted agents (trastuzumab+pertuzumab) with a taxane is much more beneficial for the treatment of HER2+ MBC. Dual HER2-targeted agents combined with a taxane appears to be the preferred application of HER2+ MBC.

Authors+Show Affiliations

Department of Radiology, The Fourth Hospital of Hebei Medical University, 12, Jiankang Road, Shijiazhuang, 050011, China.Department of Radiology, The Fourth Hospital of Hebei Medical University, 12, Jiankang Road, Shijiazhuang, 050011, China.Department of Oncology, The First Hospital of Shijiazhuang, 36, Fanxi Road, Shijiazhuang, 050011, China.Department of Obstetrics and Gynecology Two Branch, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, 050031, China.Department of Pharmacy, Hebei Children's Hospital, 133, Jianhua Street, Shijiazhuang, 050031, China.Department of Pharmacology, Hebei Medical University, 361, Zhongshan East Road, Shijiazhuang, 050017, China.Department of Pathology, Hebei University of Chinese Medicine, 3, Xingyuan Road, Luquan, Shijiazhuang, 050200, China. domd2014@126.com.Department of Cardiology, The Second Hospital of Hebei Medical University, 215, Heping West Road, Shijiazhuang, 050000, China. zzn1970@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31529262

Citation

Xie, Bao-Jie, et al. "A Network Meta-analysis On the Efficacy of HER2-targeted Agents in Combination With Taxane-containing Regimens for Treatment of HER2-positive Metastatic Breast Cancer." Breast Cancer (Tokyo, Japan), 2019.
Xie BJ, Zhu LN, Ma C, et al. A network meta-analysis on the efficacy of HER2-targeted agents in combination with taxane-containing regimens for treatment of HER2-positive metastatic breast cancer. Breast Cancer. 2019.
Xie, B. J., Zhu, L. N., Ma, C., Li, J. B., Dong, L., Zhu, Z. N., ... Gu, X. S. (2019). A network meta-analysis on the efficacy of HER2-targeted agents in combination with taxane-containing regimens for treatment of HER2-positive metastatic breast cancer. Breast Cancer (Tokyo, Japan), doi:10.1007/s12282-019-01007-9.
Xie BJ, et al. A Network Meta-analysis On the Efficacy of HER2-targeted Agents in Combination With Taxane-containing Regimens for Treatment of HER2-positive Metastatic Breast Cancer. Breast Cancer. 2019 Sep 16; PubMed PMID: 31529262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A network meta-analysis on the efficacy of HER2-targeted agents in combination with taxane-containing regimens for treatment of HER2-positive metastatic breast cancer. AU - Xie,Bao-Jie, AU - Zhu,Li-Na, AU - Ma,Can, AU - Li,Ji-Bin, AU - Dong,Lei, AU - Zhu,Zhong-Ning, AU - Ding,Tao, AU - Gu,Xin-Shun, Y1 - 2019/09/16/ PY - 2018/09/26/received PY - 2019/08/27/accepted PY - 2019/9/19/entrez KW - Metastatic breast cancer KW - Network meta-analysis KW - Targeted therapy KW - Taxanes JF - Breast cancer (Tokyo, Japan) JO - Breast Cancer N2 - PURPOSE: We performed a network meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of HER2-targeted agents in combination with taxanes and to identify the best strategy for HER2+ metastatic breast cancer (MBC). METHODS: Pubmed, Embase, the Cochrane Library, and ClinicalTrials.gov were searched for randomized controlled trials that evaluated any taxanes+HER2-targeted agents in the treatment of HER2+ MBC. The primary outcome was overall survival (OS). The secondary outcomes included overall response rate (ORR) and progression-free survival (PFS). RESULTS: A total of 13 RCTs were eligible, involving 4941 patients and 10 regimens. The result showed that single-HER2-targeted agent+a taxane did improve the effect on ORR and PFS than taxane alone, but only trastuzumab+a taxane had a significant improvement in OS outcomes. Single-HER2-targeted agent (trastuzumab) combined with taxane-based doublets (taxane+carboplatin/capecitabine/doxorubicin/bevacizumab) showed no further benefit than trastuzumab+a taxane. Doublet-HER2-targeted agents combined with a taxane(trastuzumab+pertuzumab+a taxane) showed further improvement in ORR, PFS, and all OS outcomes than single-HER2-targeted agent+a taxane. Ranking analysis based on their P-scores suggested that trastuzumab+pertuzumab+a taxane was the best combination treatment for all the efficacy outcomes. CONCLUSIONS: These findings demonstrate that combining two HER2-targeted agents (trastuzumab+pertuzumab) with a taxane is much more beneficial for the treatment of HER2+ MBC. Dual HER2-targeted agents combined with a taxane appears to be the preferred application of HER2+ MBC. SN - 1880-4233 UR - https://www.unboundmedicine.com/medline/citation/31529262/A_network_meta-analysis_on_the_efficacy_of_HER2-targeted_agents_in_combination_with_taxane-containing_regimens_for_treatment_of_HER2-positive_metastatic_breast_cancer L2 - https://dx.doi.org/10.1007/s12282-019-01007-9 DB - PRIME DP - Unbound Medicine ER -