Dual neoadjuvant blockade plus chemotherapy versus monotherapy for the treatment of women with non-metastatic HER2-positive breast cancer: a systematic review and meta-analysis

• Juan Carlos Vazquez ^[9] ; Silvia Antolin ^[1] ; Manuel Ruiz-Borrego ^[2] ; Sonia Servitja ^[3] ; Emilio Alba ^[10] ; Agusti Barnadas ^[4] ; Ana Lluch ^[5] ; Miguel Martin ^[6] ; Alvaro Rodriguez-Lescure ^[7] ; Ivan Sola ^[9] ; Xavier Bonfill ^[9] ; Gerard Urrutia ^[9] ; Pedro Sanchez-Rovira ^[8]
  1. [1] Complexo Hospitalario Universitario da Coruña

     Complexo Hospitalario Universitario da Coruña

     A Coruña, España

     
  2. [2] Hospital Universitario Virgen del Rocío

     Hospital Universitario Virgen del Rocío

     Sevilla, España

     
  3. [3] Hospital del Mar

     Hospital del Mar

     Barcelona, España

     
  4. [4] Hospital de la Santa Creu i Sant Pau

     Hospital de la Santa Creu i Sant Pau

     Barcelona, España

     
  5. [5] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  6. [6] Instituto de Investigación Sanitaria Gregorio Marañón

     Instituto de Investigación Sanitaria Gregorio Marañón

     Madrid, España

     
  7. [7] Hospital General Universitario de Elche

     Hospital General Universitario de Elche

     Elche, España

     
  8. [8] Hospital Universitario de Jaén

     Hospital Universitario de Jaén

     Jaén, España

     
  9. [9] Centro Cochrane Iberoamericano, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, España
  10. [10] UGCI Oncología Médica, Hospitales Regional y Virgen de la Victoria, Málaga, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 4 (April), 2023, págs. 941-958
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background We aimed to determine the effect of dual anti-HER2 blockade compared to monotherapy on clinically important outcomes.

    Methods We carried out a systematic review updated until July 2022. The outcomes included pathological complete response (pCR), clinical response, event-free survival, and overall survival.

    Results We identified eleven randomized clinical trials (2836 patients). When comparing paclitaxel plus dual treatment versus paclitaxel plus trastuzumab or lapatinib, dual treatment was associated with a higher probability of achieving a pathological complete response (OR 2.88, 95% CI 2.02–4.10). Addition of a taxane to an anthracycline plus cyclophosphamide and fluorouracil, plus lapatinib or trastuzumab, showed that the dual treatment was better than lapatinib alone (OR 2.47, 95% CI 1.41–4.34), or trastuzumab alone (OR 1.89, 95% CI 1.13–3.16). Dual treatment may result in an increase in survival outcomes and tumour clinical response, although such benefits are not consistent for all the combinations studied.

    Conclusions The use of dual blockade with combinations of trastuzumab and pertuzumab can be recommended for the neoadjuvant treatment of women with HER2-positive breast cancer.

    PROSPERO Registration number: CRD42018110273.