HER2+ breast cancer meta-analysis: add-on pertuzumab outperforms other HER2 inhibitors

  • Chen S & al.
  • BMC Cancer
  • 21 Oct 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • In patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, pertuzumab (P) in combination with H (trastuzumab or trastuzumab emtansine±chemotherapy) outperforms H alone in a meta-analysis.

Why this matters

  • Findings support the use of multiple HER2 inhibitors that include both P and trastuzumab in the neoadjuvant and metastatic settings.

Study design

  • Meta-analysis of 26 randomized controlled trials (n=9872) after search of PubMed, Cochrane, Science Direct, EMBASE, and ClinicalTrials.gov.
  • Funding: None.

Key results

  • Neoadjuvant setting:
    • P+H had 33% improved pathologic complete response (pCR) vs H alone (OR, 1.33; P=.006).
    • In subgroup analysis, P+H in hormone receptor (HR)-negative/HER2+ patients had 54% improved pCR than HR+/HER2+ patients (HR, 0.46; P<.001>
  • Metastatic setting:
    • P+H had 25% longer PFS than H alone (HR, 0.75; P<.001>
  • Safety:
    • P+H had significantly more rash, diarrhea, epistaxis, mucosal inflammation, and anemia than H alone.
    • P+H had no significant difference in myalgia (OR, 0.91; P=.072).
    • No differences between groups in cardiac toxicity (OR, 1.26; P=.309).

Limitations

  • Inclusion of some single-group trials and nonrandomized trials.
  • Some data missing.