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Efficacy and Safety of Anti-HER2 Targeted Therapy for Metastatic HR-Positive and HER2-Positive Breast Cancer: A

Xian-Meng Wu1, Yong-Kang Qian1, Hua-Ling Chen1

  • 1Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China.

Current Oncology (Toronto, Ont.)
|September 27, 2023
PubMed

Insights

Dual-target anti-HER2 therapies significantly improve progression-free survival (PFS) in HR+/HER2+ metastatic breast cancer (MBC). Combination regimens including dual antibody or antibody-tyrosine kinase inhibitor plus endocrine therapy or chemotherapy offer superior outcomes.

Area of Science:

  • Oncology
  • Pharmacology
  • Biostatistics

Background:

  • Hormone receptor-positive, HER2-positive (HR+/HER2+) metastatic breast cancer (MBC) presents treatment challenges despite HER2-targeted therapies.
  • Optimal combination regimens for HR+/HER2+ MBC require further investigation to improve patient outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of various anti-HER2 combination regimens in HR+/HER2+ MBC using Bayesian Network Meta-analysis.
  • To identify the most effective dual-target therapies for improving progression-free survival (PFS) and overall survival (OS).

Main Methods:

  • A systematic literature search across seven databases identified 25 randomized controlled trials.
  • Bayesian Network Meta-analysis was employed to compare progression-free survival (PFS), objective response rate (ORR), overall survival (OS), and grade 3/4 adverse events (AEs).
  • Surface Under the Cumulative Ranking Curves (SUCRA) were used to rank treatment regimens.

Main Results:

  • For patients eligible for endocrine therapy, dual-target endocrine combinations (Her2-mAb+Her2-mAb+Endo, Her2-mAb+Her2-tki+Endo) significantly improved PFS compared to endocrine therapy alone.
  • For patients unsuitable for endocrine therapy, dual-target chemotherapy combinations (Her2-mAb+Her2-tki+Chem, Her2-mAb+Her2-mAb+Chem) significantly improved PFS compared to single anti-HER2 agent plus chemotherapy.
  • Dual-target therapies demonstrated superior PFS and OS across different patient subgroups and treatment lines.

Conclusions:

  • Dual-target anti-HER2 therapies, combined with either endocrine therapy or chemotherapy, represent an optimal treatment strategy for HR+/HER2+ MBC.
  • Specific combinations like Her2-mAb+Her2-mAb+Endo and Her2-mAb+Her2-tki+Chem show promising efficacy for PFS and OS.
  • These findings support the use of dual-target therapy irrespective of treatment line in HR+/HER2+ MBC management.
Keywords:
Bayesian network meta-analysisHER2-positiveHR-positivemetastatic breast cancertargeted therapy

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