Details

Autor(en) / Beteiligte

• Wu, Yu-Tuan
• Xu, Zhou
• Zhang, Ke
• Wu, Jiu-Song
• Li, Xin
• Arshad, Bilal
• Li, Ying-Cun
• Wang, Zhong-Liang
• Li, Hong-Yuan
• Wu, Kai-Nan
• Kong, Ling-Quan

Titel

Efficacy and cardiac safety of the concurrent use of trastuzumab and anthracycline-based neoadjuvant chemotherapy for HER2-positive breast cancer: a systematic review and meta-analysis

Ist Teil von

• Therapeutics and clinical risk management, 2018-01, Vol.14, p.1789-1797

Ort / Verlag

New Zealand: Dove Medical Press Limited

Erscheinungsjahr

2018

Quelle

Taylor & Francis Journals Auto-Holdings Collection

Beschreibungen/Notizen

• The concurrent use of trastuzumab and anthracycline-based neoadjuvant chemotherapy (NAC) has been proposed to improve the pathologic complete response (pCR) rate, although there are conflicting views about its efficacy and safety. The purpose of this study was to evaluate the efficacy and cardiac safety of the concurrent use of trastuzumab and anthracycline-based NAC for human epidermal growth factor receptor 2 (HER2)-positive locally advanced breast cancer. We systematically searched PubMed, Embase, and Cochrane databases from inception until July 1, 2017, for relevant articles. A total of 13 studies were included in the meta-analysis. The results showed that the pCR rate was significantly higher in the concurrent use of trastuzumab and anthracycline group (45%) than that in the nonconcurrent use group (32%) (OR: 2.36, 95% CI: 1.69-3.30, <0.0001). Besides, the pooled absolute rate of breast conservation surgery (BCS) was 48% (95% CI: 0.35-0.61) and 38% (95% CI: 0.14-0.62) in the experimental and control groups, respectively (OR: 1.10, 95% CI: 0.64-1.90, =0.73). No significant differences were found in the left ventricular ejection fraction (LVEF), which decreased by >10% (OR: 1.26, 95% CI: 0.55-2.88, =0.59), and in terms of cardiac failure (OR: 2.17, 95% CI: 0.24-19.84, =0.49), when comparing the concurrent use of trastuzumab and anthracyclines with their nonconcurrent use. In conclusion, the concurrent use of trastuzumab and anthracycline-based NAC for certain HER2-positive locally advanced breast cancers significantly improves the pCR rates without obvious increases in the cardiotoxicity.