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Pyrotinib for HER2-positive metastatic breast cancer: a systematic review and meta-analysis
Wenyu Hu1, Jixin Yang1, Ze Zhang2
1Surgery of Thyroid Breast Vascular Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
Background:
Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer patients continue to progress despite multiple anti-HER2-targeted treatments. A number of studies have found that Pyrotinib, a small-molecule pan-ErbB receptor tyrosine kinase inhibitor (TKI), is effective in treating patients with HER2-positive metastatic breast cancer. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Pyrotinib in the treatment of HER2-positive metastatic breast cancer.
Methods:
PubMed, Embase, Web of Science, and Cochrane Library databases were searched until February 2022. Research on HER2-positive metastatic breast cancer being treated with Pyrotinib in any line of therapy was included, both prospective and retrospective. Statistical pooling and meta-analysis of data from the included studies were performed to explore the efficacy and safety of Pyrotinib in HER2-positive metastatic breast cancer.
Results:
In this meta-analysis, 23 studies were included. The overall objective response rate was 0.49 (95% CI: 0.40, 0.58) for Pyrotinib in HER2-positive metastatic breast cancer and 0.52 (95% CI: 0.32, 0.71) in those with brain metastases. The objective response rate of Pyrotinib was superior to that of other second-line therapeutics in comparison (RR =1.38, 95% CI: 1.25, 1.52), but was relatively inferior to trastuzumab emtansine (T-DM1) (RR =0.82, 95% CI: 0.36, 1.85). The combined median progression-free survivals (PFSs) for Pyrotinib in metastatic breast cancer and those with brain metastases were 8.2 (95% CI: 6.8, 9.5) months and 8.9 (95% CI: 6.2, 11.7) months, respectively. The most common adverse reaction was diarrhea with an all-grade incidence of 0.84 (95% CI: 0.74, 0.92), followed by nausea and vomiting of 0.52 (95% CI: 0.36, 0.68).
Conclusions:
In any line of treatment for HER2-positive metastatic breast cancer, the Pyrotinib-containing regimens demonstrated considerable tumor response, disease control, and survival with manageable adverse effects.
Insights
Pyrotinib shows significant efficacy in treating HER2-positive metastatic breast cancer, offering good tumor response and survival benefits. This pan-ErbB inhibitor provides manageable adverse effects for patients with advanced disease.
Area of Science:
- Oncology
- Pharmacology
Background:
- Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer remains a challenge despite targeted therapies.
- Pyrotinib, a small-molecule pan-ErbB receptor tyrosine kinase inhibitor (TKI), has emerged as a potential treatment option.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of Pyrotinib in treating HER2-positive metastatic breast cancer.
Main Methods:
- Searched PubMed, Embase, Web of Science, and Cochrane Library databases up to February 2022.
- Included prospective and retrospective studies of Pyrotinib for HER2-positive metastatic breast cancer.
- Performed statistical pooling and meta-analysis to evaluate efficacy and safety.
Main Results:
- Analyzed 23 studies, revealing an overall objective response rate (ORR) of 0.49 for Pyrotinib in HER2-positive metastatic breast cancer.
- Pyrotinib showed a superior ORR compared to other second-line therapies but was inferior to trastuzumab emtansine (T-DM1).
- Median progression-free survival (PFS) was 8.2 months; common adverse events included diarrhea (0.84 incidence) and nausea/vomiting (0.52 incidence).
Conclusions:
- Pyrotinib-containing regimens demonstrate considerable tumor response, disease control, and survival in HER2-positive metastatic breast cancer.
- The treatment offers manageable adverse effects, including diarrhea, nausea, and vomiting.
- Pyrotinib is an effective option in any line of therapy for this patient population.
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