- 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.
- Meta-analysis of 26 randomized controlled trials (n=9872) after search of PubMed, Cochrane, Science Direct, EMBASE, and ClinicalTrials.gov.
- Funding: None.
- 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>
- 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).
- Inclusion of some single-group trials and nonrandomized trials.
- Some data missing.