Efficacy of Anti-HER2 Agents in Combination With Adjuvant or Neoadjuvant Chemotherapy for Early and Locally Advanced HER2-Positive Breast Cancer Patients: A Network Meta-Analysis.
Efficacy of Anti-HER2 Agents in Combination With Adjuvant or Neoadjuvant Chemotherapy for Early and Locally Advanced HER2-Positive Breast Cancer Patients: A Network Meta-Analysis.
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DOI：
10.3389/fonc.2018.00156
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发表时间：
2018
影响因子：
4.7
通讯作者：
Olopade O
中科院分区：
文献类型：
--
作者：
Debiasi M;Polanczyk CA;Ziegelmann P;Barrios C;Cao H;Dignam JJ;Goss P;Bychkovsky B;Finkelstein DM;Guindalini RS;Filho P;Albuquerque C;Reinert T;de Azambuja E;Olopade O
在不同的随机临床试验中，对her2阳性乳腺癌患者的几种（新）辅助治疗进行了比较。由于不可能对所有这些治疗方案进行充分的两两比较试验，网络荟萃分析为循证治疗提供了更详细的推断机会。纳入了比较两种或多种不同（neo）辅助治疗her2阳性乳腺癌患者的II/III期随机临床试验。相对治疗效果汇集在两个单独的网络荟萃分析中，用于总生存期（OS）和无病生存期（DFS）。17项临床试验符合我们的资格标准。基于结果的可获得性，创建了两种不同的试验网络：OS网络（15项试验：37,837例患者）；和DFS网络（17项试验：40,992例患者）。两项研究——ExteNET和NeoSphere试验——只包括在这个DFS网络中，因为OS数据尚未报道。双重抗her2阻断的概念被证明是OS和DFS的最佳选择。就OS而言，化疗(CT) +曲妥珠单抗(T)和拉帕替尼(L)以及CT + T +帕妥珠单抗(P)可能是最佳的治疗方案，分别为62.47%和22.06%。在DFS网络中，CT + T + Neratinib (N)是最佳治疗方案，占50.55%，其次是CT + T + P（26.59%）和CT + T + L（20.62%）。该网络荟萃分析表明，曲妥珠单抗联合拉帕替尼或帕妥珠单抗的双重抗her2阻断可能是her2阳性乳腺癌患者在（新）辅助治疗环境中获得OS增益的最佳治疗选择。Aphinity试验和曲妥珠单抗序贯使用neratinib仍有望获得成熟的OS结果，在我们的分析中，该治疗在DFS方面表现最佳。
Several (neo)adjuvant treatments for patients with HER2-positive breast cancer have been compared in different randomized clinical trials. Since it is not feasible to conduct adequate pairwise comparative trials of all these therapeutic options, network meta-analysis offers an opportunity for more detailed inference for evidence-based therapy. Phase II/III randomized clinical trials comparing two or more different (neo)adjuvant treatments for HER2-positive breast cancer patients were included. Relative treatment effects were pooled in two separate network meta-analyses for overall survival (OS) and disease-free survival (DFS). 17 clinical trials met our eligibility criteria. Two different networks of trials were created based on the availability of the outcomes: OS network (15 trials: 37,837 patients); and DFS network (17 trials: 40,992 patients). Two studies—the ExteNET and the NeoSphere trials—were included only in this DFS network because OS data have not yet been reported. The concept of the dual anti-HER2 blockade proved to be the best option in terms of OS and DFS. Chemotherapy (CT) plus trastuzumab (T) and lapatinib (L) and CT + T + Pertuzumab (P) are probably the best treatment options in terms of OS, with 62.47% and 22.06%, respectively. In the DFS network, CT + T + Neratinib (N) was the best treatment option with 50.55%, followed by CT + T + P (26.59%) and CT + T + L (20.62%). This network meta-analysis suggests that dual anti-HER2 blockade with trastuzumab plus either lapatinib or pertuzumab are probably the best treatment options in the (neo)adjuvant setting for HER2-positive breast cancer patients in terms of OS gain. Mature OS results are still expected for the Aphinity trial and for the sequential use of trastuzumab followed by neratinib, the treatment that showed the best performance in terms of DFS in our analysis.
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影响因子：
105.7
作者：
Mills, Edward J.;Thorlund, Kristian;Ioannidis, John P. A.
通讯作者：
Ioannidis, John P. A.
影响因子：
3.6
作者：
Bachman, KE;Argani, P;Park, BH
通讯作者：
Park, BH
影响因子：
28.4
作者：
Global Burden of Disease Cancer Collaboration;Fitzmaurice C;Allen C;Barber RM;Barregard L;Bhutta ZA;Brenner H;Dicker DJ;Chimed-Orchir O;Dandona R;Dandona L;Fleming T;Forouzanfar MH;Hancock J;Hay RJ;Hunter-Merrill R;Huynh C;Hosgood HD;Johnson CO;Jonas JB;Khubchandani J;Kumar GA;Kutz M;Lan Q;Larson HJ;Liang X;Lim SS;Lopez AD;MacIntyre MF;Marczak L;Marquez N;Mokdad AH;Pinho C;Pourmalek F;Salomon JA;Sanabria JR;Sandar L;Sartorius B;Schwartz SM;Shackelford KA;Shibuya K;Stanaway J;Steiner C;Sun J;Takahashi K;Vollset SE;Vos T;Wagner JA;Wang H;Westerman R;Zeeb H;Zoeckler L;Abd-Allah F;Ahmed MB;Alabed S;Alam NK;Aldhahri SF;Alem G;Alemayohu MA;Ali R;Al-Raddadi R;Amare A;Amoako Y;Artaman A;Asayesh H;Atnafu N;Awasthi A;Saleem HB;Barac A;Bedi N;Bensenor I;Berhane A;Bernabé E;Betsu B;Binagwaho A;Boneya D;Campos-Nonato I;Castañeda-Orjuela C;Catalá-López F;Chiang P;Chibueze C;Chitheer A;Choi JY;Cowie B;Damtew S;das Neves J;Dey S;Dharmaratne S;Dhillon P;Ding E;Driscoll T;Ekwueme D;Endries AY;Farvid M;Farzadfar F;Fernandes J;Fischer F;G/Hiwot TT;Gebru A;Gopalani S;Hailu A;Horino M;Horita N;Husseini A;Huybrechts I;Inoue M;Islami F;Jakovljevic M;James S;Javanbakht M;Jee SH;Kasaeian A;Kedir MS;Khader YS;Khang YH;Kim D;Leigh J;Linn S;Lunevicius R;El Razek HMA;Malekzadeh R;Malta DC;Marcenes W;Markos D;Melaku YA;Meles KG;Mendoza W;Mengiste DT;Meretoja TJ;Miller TR;Mohammad KA;Mohammadi A;Mohammed S;Moradi-Lakeh M;Nagel G;Nand D;Le Nguyen Q;Nolte S;Ogbo FA;Oladimeji KE;Oren E;Pa M;Park EK;Pereira DM;Plass D;Qorbani M;Radfar A;Rafay A;Rahman M;Rana SM;Søreide K;Satpathy M;Sawhney M;Sepanlou SG;Shaikh MA;She J;Shiue I;Shore HR;Shrime MG;So S;Soneji S;Stathopoulou V;Stroumpoulis K;Sufiyan MB;Sykes BL;Tabarés-Seisdedos R;Tadese F;Tedla BA;Tessema GA;Thakur JS;Tran BX;Ukwaja KN;Uzochukwu BSC;Vlassov VV;Weiderpass E;Wubshet Terefe M;Yebyo HG;Yimam HH;Yonemoto N;Younis MZ;Yu C;Zaidi Z;Zaki MES;Zenebe ZM;Murray CJL;Naghavi M
通讯作者：
Naghavi M
DOI：
10.1158/1078-0432.ccr-14-1760
发表时间：
2015-07-01
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
DeMichele A;Yee D;Berry DA;Albain KS;Benz CC;Boughey J;Buxton M;Chia SK;Chien AJ;Chui SY;Clark A;Edmiston K;Elias AD;Forero-Torres A;Haddad TC;Haley B;Haluska P;Hylton NM;Isaacs C;Kaplan H;Korde L;Leyland-Jones B;Liu MC;Melisko M;Minton SE;Moulder SL;Nanda R;Olopade OI;Paoloni M;Park JW;Parker BA;Perlmutter J;Petricoin EF;Rugo H;Symmans F;Tripathy D;van't Veer LJ;Viscusi RK;Wallace A;Wolf D;Yau C;Esserman LJ
通讯作者：
Esserman LJ
影响因子：
4.5
作者：
Hoaglin, David C.;Hawkins, Neil;Barrett, Annabel
通讯作者：
Barrett, Annabel