The efficacy of ado-trastuzumab emtansine in patients with ERBB2-aberrant non-small cell lung cancer: a systematic review.
The efficacy of ado-trastuzumab emtansine in patients with ERBB2-aberrant non-small cell lung cancer: a systematic review.
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ado-曲妥珠单抗 emtansine 对 ERBB2 异常非小细胞肺癌患者的疗效：系统评价
DOI：
10.21037/tcr-19-2759
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发表时间：
2020-08
影响因子：
0.9
通讯作者：
Xia Y
中科院分区：
文献类型：
--
作者：
Huang X;Jin R;Lou L;Zhao J;Xia L;Zhao J;Li W;Xu Z;Xia Y
背景：ERBB2基因异常是肺癌的致癌改变。然而，已报道的阿多曲妥珠单抗(T-DM1)的治疗效果各不相同。因此，我们评估了T-DM1治疗不同类型ERBB2异常的有效性和安全性。方法系统检索PubMed和EMBASE数据库自创始至2020年6月期间有关T-DM1治疗ERBB2基因突变肺癌的原始文献和会议摘要。用R软件进行统计分析。结果在5项研究中，共有120例患者存在各种ERBB2异常。ERBB2上调(基因扩增和/或蛋白过度表达)在患有腺癌的吸烟者中更常见，而突变在患有腺癌的女性非吸烟者中更常见。ERBB2像差的总客观有效率(ORR)为29%[95%可信区间(CI)：15~56%]。亚组分析显示ERBB2基因突变、ERBB2基因扩增、ERBB2蛋白过表达的OR率分别为41%(95%CI：11~70%)、66%(95%CI：11~100%)和3%(95%CI：0~9%)。值得注意的是，伴随ERBB2上调和突变，ORR为44%(95%CI：25-63%)。此外，蛋白过度表达+基因突变的ORR为26%(95%CI：0~54%)，而基因扩增+蛋白质过度表达+基因突变三重突变的ORR为80%(95%CI：50~100%)。结论T-DM1可能是靶向ERBB2突变或/和扩增的肺癌的关键分子。
Background ERBB2 aberrations are oncogenic alterations in lung cancer. However, the reported therapeutic efficacy of ado-trastuzumab emtansine (T-DM1) varied. We therefore evaluated the efficacy and safety of T-DM1 in treating different types of ERBB2 aberrations. Methods We conducted a systematic search for original articles and meeting abstracts about ERBB2-aberrant lung cancer treating with T-DM1 in PubMed and EMBASE databases from inception to June, 2020. Statistical analysis was carried out in R software. Results A total of 120 patients with various ERBB2 aberrations were identified in five studies. ERBB2 upregulation (gene amplification and/or protein overexpression) was more common in smokers with adenocarcinoma, whereas mutations were more common in female non-smokers with adenocarcinoma. The overall objective response rate (ORR) for ERBB2 aberrations was 29% [95% confidence interval (CI): 15–56%]. Subgroup analysis showed an ORR of 41% (95% CI: 11–70%) for ERBB2 gene mutation, 66% (95% CI: 11–100%) for ERBB2 gene amplification, and 3% (95% CI: 0–9%) for ERBB2 protein overexpression. Notably, the ORR was 44% (95% CI: 25–63%) upon concomitant ERBB2 upregulation and mutation. Furthermore, the ORR was 26% (95% CI: 0–54%) for protein overexpression plus gene mutation but up to 80% (95% CI: 50–100%) for triple aberrations: gene amplification plus protein overexpression and gene mutation. Conclusions Collectively, T-DM1 might be a critical agent targeting ERBB2 mutated or/and amplified lung cancers.