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Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis

BACKGROUND: Originator trastuzumab (Herceptin®; H) is an antibody-targeted therapy to treat patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC). We investigated the overall survival (OS) advantage conferred by the addition of H to chemotherapy for HER2+...

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Autores principales: Wilson, Florence R., Coombes, Megan E., Brezden-Masley, Christine, Yurchenko, Mariya, Wylie, Quinlan, Douma, Reuben, Varu, Abhishek, Hutton, Brian, Skidmore, Becky, Cameron, Chris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237027/
https://www.ncbi.nlm.nih.gov/pubmed/30428932
http://dx.doi.org/10.1186/s13643-018-0854-y
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author Wilson, Florence R.
Coombes, Megan E.
Brezden-Masley, Christine
Yurchenko, Mariya
Wylie, Quinlan
Douma, Reuben
Varu, Abhishek
Hutton, Brian
Skidmore, Becky
Cameron, Chris
author_facet Wilson, Florence R.
Coombes, Megan E.
Brezden-Masley, Christine
Yurchenko, Mariya
Wylie, Quinlan
Douma, Reuben
Varu, Abhishek
Hutton, Brian
Skidmore, Becky
Cameron, Chris
author_sort Wilson, Florence R.
collection PubMed
description BACKGROUND: Originator trastuzumab (Herceptin®; H) is an antibody-targeted therapy to treat patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC). We investigated the overall survival (OS) advantage conferred by the addition of H to chemotherapy for HER2+ EBC patients and how the OS advantage changed over time. METHODS: A systematic literature review (SLR) identified randomized controlled trials (RCTs) and non-randomized studies (NRSs) published from January 1, 1990 to January 19, 2017, comparing systemic therapies used in the neoadjuvant/adjuvant settings to treat HER2+ EBC patients. Bayesian cumulative network meta-analyses (cNMAs) of OS were conducted to assess the published literature over time. Heterogeneity was assessed through sensitivity and subgroup analyses. RESULTS: The SLR identified 31 unique studies (28 RCTs, 3 NRSs) included in the OS analyses from 2008 to 2016. In the reference case cNMA (RCTs alone), initial evidence demonstrated an OS advantage for H/chemotherapy compared with chemotherapy alone in HER2+ EBC patients. As additional OS data were published, the precision around this survival benefit strengthened over time. Both H/anthracycline-containing chemotherapy and H/non-anthracycline-containing chemotherapy regimens provided similar OS advantages for HER2+ EBC patients. CONCLUSION: This analysis represents the most comprehensive SLR/cNMA to date of published OS data in HER2+ EBC studies. These findings demonstrate why H/chemotherapy is now the established standard of care in HER2+ EBC. In the case of H, the benefits of early patient access far outweighed the risk of waiting for more precise information. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017055763 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13643-018-0854-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-62370272018-11-23 Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis Wilson, Florence R. Coombes, Megan E. Brezden-Masley, Christine Yurchenko, Mariya Wylie, Quinlan Douma, Reuben Varu, Abhishek Hutton, Brian Skidmore, Becky Cameron, Chris Syst Rev Research BACKGROUND: Originator trastuzumab (Herceptin®; H) is an antibody-targeted therapy to treat patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC). We investigated the overall survival (OS) advantage conferred by the addition of H to chemotherapy for HER2+ EBC patients and how the OS advantage changed over time. METHODS: A systematic literature review (SLR) identified randomized controlled trials (RCTs) and non-randomized studies (NRSs) published from January 1, 1990 to January 19, 2017, comparing systemic therapies used in the neoadjuvant/adjuvant settings to treat HER2+ EBC patients. Bayesian cumulative network meta-analyses (cNMAs) of OS were conducted to assess the published literature over time. Heterogeneity was assessed through sensitivity and subgroup analyses. RESULTS: The SLR identified 31 unique studies (28 RCTs, 3 NRSs) included in the OS analyses from 2008 to 2016. In the reference case cNMA (RCTs alone), initial evidence demonstrated an OS advantage for H/chemotherapy compared with chemotherapy alone in HER2+ EBC patients. As additional OS data were published, the precision around this survival benefit strengthened over time. Both H/anthracycline-containing chemotherapy and H/non-anthracycline-containing chemotherapy regimens provided similar OS advantages for HER2+ EBC patients. CONCLUSION: This analysis represents the most comprehensive SLR/cNMA to date of published OS data in HER2+ EBC studies. These findings demonstrate why H/chemotherapy is now the established standard of care in HER2+ EBC. In the case of H, the benefits of early patient access far outweighed the risk of waiting for more precise information. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017055763 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13643-018-0854-y) contains supplementary material, which is available to authorized users. BioMed Central 2018-11-14 /pmc/articles/PMC6237027/ /pubmed/30428932 http://dx.doi.org/10.1186/s13643-018-0854-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Wilson, Florence R.
Coombes, Megan E.
Brezden-Masley, Christine
Yurchenko, Mariya
Wylie, Quinlan
Douma, Reuben
Varu, Abhishek
Hutton, Brian
Skidmore, Becky
Cameron, Chris
Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
title Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
title_full Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
title_fullStr Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
title_full_unstemmed Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
title_short Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
title_sort herceptin® (trastuzumab) in her2-positive early breast cancer: a systematic review and cumulative network meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237027/
https://www.ncbi.nlm.nih.gov/pubmed/30428932
http://dx.doi.org/10.1186/s13643-018-0854-y
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