HER2-targeted therapy prolongs survival in patients with HER2-positive breast cancer and intracranial metastatic disease: a systematic review and meta-analysis.
HER2-targeted therapy prolongs survival in patients with HER2-positive breast cancer and intracranial metastatic disease: a systematic review and meta-analysis.
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DOI：
10.1093/noajnl/vdaa136
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Das S
中科院分区：
文献类型：
--
作者：
Erickson AW;Ghodrati F;Habbous S;Jerzak KJ;Sahgal A;Ahluwalia MS;Das S
颅内转移性疾病 (IMD) 是人类表皮生长因子受体 2 (HER2) 阳性乳腺癌的一种严重且已知的并发症。靶向治疗对于 HER2 阳性乳腺癌和 IMD 患者的作用尚不清楚。在这项研究中，我们试图评估 HER2 靶向治疗对 HER2 阳性乳腺癌 IMD 的效果。我们检索了 MEDLINE、EMBASE、CENTRAL 和灰色文献来源，以查找报告接受 HER2 靶向治疗的 IMD 患者的生存、缓解和安全性结果的干预性和观察性研究。我们通过荟萃分析汇总结果，并通过森林图分层和荟萃回归检查混杂因素的影响。使用 GRADE (PROSPERO CRD42020161209) 评估证据质量。总共纳入 97 项研究（37 项干预性研究和 60 项观察性研究）。与非靶向治疗相比，HER2 靶向治疗可延长总生存期（风险比 [HR] 0.47；95% 置信区间 [CI]，0.39–0.56），但无显着延长无进展生存期（HR 0.52；95% CI，0.27–1.02）；颅内客观缓解率为19%（95% CI，12-27%），颅内疾病控制率为62%（95% CI，55-69%），颅内完全缓解率为0%（95% CI，0-0.01%），3级以上不良事件发生率为26%（95% CI，11-45%）。 40% (39/97) 的研究存在较高偏倚风险。这些发现支持全身 HER2 靶向治疗在治疗 HER2 阳性转移性乳腺癌 IMD 患者中的潜在作用。
Intracranial metastatic disease (IMD) is a serious and known complication of human epidermal growth factor receptor 2 (HER2)-positive breast cancer. The role of targeted therapy for patients with HER2-positive breast cancer and IMD remains unclear. In this study, we sought to evaluate the effect of HER2-targeted therapy on IMD from HER2-positive breast cancer. We searched MEDLINE, EMBASE, CENTRAL, and gray literature sources for interventional and observational studies reporting survival, response, and safety outcomes for patients with IMD receiving HER2-targeted therapy. We pooled outcomes through meta-analysis and examined confounder effects through forest plot stratification and meta-regression. Evidence quality was evaluated using GRADE (PROSPERO CRD42020161209). A total of 97 studies (37 interventional and 60 observational) were included. HER2-targeted therapy was associated with prolonged overall survival (hazard ratio [HR] 0.47; 95% confidence interval [CI], 0.39–0.56) without significantly prolonged progression-free survival (HR 0.52; 95% CI, 0.27–1.02) versus non-targeted therapy; the intracranial objective response rate was 19% (95% CI, 12–27%), intracranial disease control rate 62% (95% CI, 55–69%), intracranial complete response rate 0% (95% CI, 0–0.01%), and grade 3+ adverse event rate 26% (95% CI, 11–45%). Risk of bias was high in 40% (39/97) of studies. These findings support a potential role for systemic HER2-targeted therapy in the treatment of patients with IMD from HER2-positive metastatic breast cancer.
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影响因子：
3.8
作者：
Bartsch R;De Vries C;Pluschnig U;Dubsky P;Bago-Horvath Z;Gampenrieder SP;Rudas M;Mader RM;Rottenfusser A;Wiltschke C;Gnant M;Zielinski CC;Steger GG
通讯作者：
Steger GG
影响因子：
8.4
作者：
Bonneau, Claire;Paintaud, Gilles;Gutierrez, Maya
通讯作者：
Gutierrez, Maya
影响因子：
28.4
作者：
Borges, Virginia F.;Ferrario, Cristiano;Hamilton, Erika
通讯作者：
Hamilton, Erika
影响因子：
50.5
作者：
de Azambuja, E.;Zardavas, D.;Awada, A.
通讯作者：
Awada, A.
影响因子：
51.1
作者：
Bachelot, Thomas;Romieu, Gilles;Labbe-Devilliers, Catherine
通讯作者：
Labbe-Devilliers, Catherine