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Targeted neoadjuvant therapy in the HER-2-positive breast cancer patients: a systematic review and meta-analysis

Wenhua Ma1, Fugang Zhao2, Changpeng Zhou1

  • 1Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China.

Oncotargets and Therapy
|January 19, 2019
PubMed
Abstract

Insights

Lapatinib showed less efficacy and more adverse effects than trastuzumab in HER-2 positive breast cancer. Combining both drugs with chemotherapy improved pathological complete response but did not significantly enhance survival rates.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • HER-2 positive breast cancer requires targeted therapies.
  • Lapatinib and trastuzumab are HER-2 targeted agents.
  • Chemotherapy is a standard treatment for breast cancer.

Purpose of the Study:

  • To compare the efficacy and safety of lapatinib versus trastuzumab, both alone and in combination with chemotherapy.
  • To evaluate these treatments in HER-2 positive breast cancer patients undergoing neoadjuvant therapy.

Main Methods:

  • A systematic literature search was conducted across multiple databases.
  • Keywords included "breast cancer", "preoperative", "neo-adjuvant", "lapatinib", and "trastuzumab".
  • Meta-analysis was used to synthesize data from controlled trials up to December 2017.

Main Results:

  • Chemotherapy plus lapatinib was less effective and safe than chemotherapy plus trastuzumab regarding pathological complete response (PCR) and tall PCR (tPCR).
  • Combining chemotherapy with both lapatinib and trastuzumab significantly improved PCR and tPCR compared to trastuzumab alone.
  • Increased incidence of diarrhea, hepatic toxicity, and skin rash was observed with lapatinib-containing regimens.

Conclusions:

  • Lapatinib demonstrated lower efficacy and higher adverse event rates than trastuzumab.
  • The combination of chemotherapy with both lapatinib and trastuzumab enhanced PCR and tPCR but did not significantly improve survival outcomes.
  • Lapatinib-containing regimens were associated with increased gastrointestinal and dermatological toxicities.
Keywords:
HER-2-positivebreast cancerlapatinibneoadjuvanttrastuzumab

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