Adjuvant trastuzumab regimen for HER2-positive early-stage breast cancer: a systematic review and meta-analysis. Issue 8 (3rd August 2019)

• Record Type: Journal Article
• Authors: Genuino, Anne Julienne; Chaikledkaew, Usa; The, Due Ong; Reungwetwattana, Thanyanan; Thakkinstian, Ammarin
• Is Part Of: Expert review of clinical pharmacology. Volume 12:Issue 8(2019)
• Page Start: 815
• Page End: 824
• Publication Date: 2019-08-03
• Subjects: Adjuvant chemotherapy -- breast cancer -- HER2-positive -- meta-analysis -- systematic review -- trastuzumab; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1080/17512433.2019.1637252
• Languages: English
• ISSNs: 1751-2433

Abstract

ABSTRACT: Objective : Breast cancer remains to be the globally leading female cancer. About 15% to 20% of breast cancers have human epidermal growth factor receptor 2 (HER2)-positive tumors – a more aggressive breast cancer subtype with shortened survival. In the light of new and updated trial data on trastuzumab therapy for HER2-positive early-stage breast cancer (EBC), we conducted a systematic review and meta-analysis to update the pooling of its relative treatment effects. Methods : Systematic search was performed through Pubmed and Scopus to identify studies comparing survival outcomes and risks of heart toxicity effects of adjuvant trastuzumab with chemotherapy versus chemotherapy alone for HER2-positive EBC patients. Results : Based on the eight included studies in the review, combining trastuzumab with chemotherapy continues to show lowered death and relapse risks by one-third. The decision to initiate trastuzumab, however, needs to be prudently deliberated as two to three times more cardiotoxicity risk was shown to be associated with its use. Conclusion : Administering adjuvant trastuzumab in a weekly cycle concurrently with anthracycline-taxane chemotherapy regimen appears to be a preferable option to optimize its favorable effect in improving DFS and to prevent significantly higher risk for cardiotoxic effects.