Comparative efficacy and safety of targeted therapy and immunotherapy for HER2-positive breast cancer: a systematic review and network meta-analyses

Suyu Gu; Yuting Liu; Yufan Huang; Wenzheng Lin; Ke Li

doi:10.3389/fonc.2024.1331055

Comparative efficacy and safety of targeted therapy and immunotherapy for HER2-positive breast cancer: a systematic review and network meta-analyses

Front Oncol. 2024 Apr 3:14:1331055. doi: 10.3389/fonc.2024.1331055. eCollection 2024.

Authors

Suyu Gu^#^{1

2}, Yuting Liu^#³, Yufan Huang^#¹, Wenzheng Lin^{1

2}, Ke Li^{1

2}

Affiliations

¹ Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China.
² Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China.
³ Department of Eighth Internal Medicine, Shenyang Traditional Chinese Medicine Hospital, Shenyang, China.

^# Contributed equally.

Abstract

Background: In recent years, novel therapies targeting specific molecular pathways and immunotherapies have exhibited promising outcomes for treating human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Our work aimed to assess the effectiveness and safety of these emerging treatment regimens for this disease.

Material and methods: We systematically searched databases including PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials their inception to August 2023 to identify relevant randomized controlled trials (RCTs). The quality of eligible RCTs was evaluated with the Cochrane risk-of-bias tool, version 2 (RoB2). Investigated outcomes encompassed progression-free survival (PFS), overall survival (OS), disease-free survival (DFS), pathologic complete remission (pCR), and adverse events (AEs). They were expressed as hazard ratio (HR) with 95% conference intervals (CI) or risk ratio (RR) with 95% CI.

Results: Our analysis identified a total of 28 RCTs suitable for inclusion in the NMA. Regarding the PFS, all these treatment regimens exhibited comparable effectiveness. In terms of OS, Capecitabine+Trastuzumab, Lapatinib+Trastuzumab and Pyrotinib+Capecitabine exhibited better effect compared to other treatments. Regarding pCR and AEs, all these treatment regimens exhibited comparable effectiveness, especially Lapatinib+Trastuzumab and Pyrotinib+Capecitabine.

Conclusion: Our study highlights the prominent role of targeted therapies and immunotherapies in treating HER2-positive breast cancer. The efficacy of trastuzumab-containing regimens was superior to other treatment options, while maintaining a comparable safety profile. Based on these findings, trastuzumab-containing regimens emerge as a preferable and recommended choice in clinical practice for managing HER2-positive breast cancer.

Systematic review registration: PROSPERO, identifier CRD42023414348.

Keywords: HER2-positive; breast cancer; efficacy; immunotherapies; meta-analysis; safety.

Publication types

Systematic Review

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.