- A meta-analysis finds that in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer:
- Adjuvant trastuzumab is no better than neoadjuvant trastuzumab.
- Mastectomy is better than breast-conserving surgery (BCS), but only in those failing to receive trastuzumab.
Why this matters
- This is among the first meta-analyses of its kind for patients with HER2+ early breast cancer.
- Meta-analysis of 12 clinical trials (N=2366) identified from a search of PubMed, Embase, Web of Science, and Cochrane Library.
- Funding: None disclosed.
- No difference in OS between adjuvant trastuzumab and neoadjuvant trastuzumab (OR, 1.04; 95% CI, 0.47-2.33).
- Mastectomy had lower local-regional recurrence than BCS (OR, 0.58; 95% CI, 0.38-0.89), but subgroup analysis found:
- Mastectomy was better than BCS only in the absence of trastuzumab (OR, 0.52; 95% CI, 0.31-0.88).
- Mastectomy and BCS were equally effective in patients who received trastuzumab (OR, 0.71; 95% CI, 0.34-1.49).
- Small number of studies, low sample size.
- Subgroup analysis was only conducted on the subset of studies (n=5) in which trastuzumab use was documented.