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Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis

BACKGROUND: Although trastuzumab has been shown to be beneficial for treating patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, information regarding its benefits is limited to very low-risk cases with tumours ≤1 cm and without lymphatic metastases (pT1abN0). The...

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Autores principales: Lee, Hye Yoon, Shin, In-Soo, Rim, Chai Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154451/
https://www.ncbi.nlm.nih.gov/pubmed/32309334
http://dx.doi.org/10.21037/atm.2020.01.81
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author Lee, Hye Yoon
Shin, In-Soo
Rim, Chai Hong
author_facet Lee, Hye Yoon
Shin, In-Soo
Rim, Chai Hong
author_sort Lee, Hye Yoon
collection PubMed
description BACKGROUND: Although trastuzumab has been shown to be beneficial for treating patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, information regarding its benefits is limited to very low-risk cases with tumours ≤1 cm and without lymphatic metastases (pT1abN0). The present meta-analysis integrates information from literature and determines the benefit of trastuzumab in pT1abN0, HER2-positive breast cancer patients. METHODS: PubMed, MEDLINE, and EMBASE databases were searched for studies published before Sep 30, 2019. Our primary endpoint was tumor recurrence, whether provided as overall or distant recurrences. RESULTS: Seven studies involving 1,181 patients with pT1abN0, HER2-positive breast cancer were included in the systemic review. The median follow-up periods ranged from 37 to 78 months. The patients in the trastuzumab arm had generally inferior profiles such as higher rate of T1b, grade 3, and hormone negative cases, among available studies. Concomitant chemotherapy was more commonly applied in the trastuzumab arm (75–100% vs. 0–42%), and the hormone therapy application was similar in both arms (20–66%). In a pooled analysis of seven available studies, patients treated with trastuzumab had less overall recurrence relative to controls, with an odds ratio of 0.201 [95% confidence interval (CI): 0.100–0.404, P<0.001]. Five studies were available for a pooled analysis of distant recurrence. Although the results were not significant (P=0.115), distant recurrence did not occur in 237 patients treated with trastuzumab, but did occur in 16 out of 436 control patients. The odds ratio for distant recurrence was 0.328 (95% CI: 0.082–1.311). CONCLUSIONS: The adjuvant treatment including trastuzumab was shown to reduce overall recurrence. Distant recurrence may also be reduced, as it did not occur among the 237 patients who underwent trastuzumab treatment.
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spelling pubmed-71544512020-04-17 Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis Lee, Hye Yoon Shin, In-Soo Rim, Chai Hong Ann Transl Med Original Article BACKGROUND: Although trastuzumab has been shown to be beneficial for treating patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, information regarding its benefits is limited to very low-risk cases with tumours ≤1 cm and without lymphatic metastases (pT1abN0). The present meta-analysis integrates information from literature and determines the benefit of trastuzumab in pT1abN0, HER2-positive breast cancer patients. METHODS: PubMed, MEDLINE, and EMBASE databases were searched for studies published before Sep 30, 2019. Our primary endpoint was tumor recurrence, whether provided as overall or distant recurrences. RESULTS: Seven studies involving 1,181 patients with pT1abN0, HER2-positive breast cancer were included in the systemic review. The median follow-up periods ranged from 37 to 78 months. The patients in the trastuzumab arm had generally inferior profiles such as higher rate of T1b, grade 3, and hormone negative cases, among available studies. Concomitant chemotherapy was more commonly applied in the trastuzumab arm (75–100% vs. 0–42%), and the hormone therapy application was similar in both arms (20–66%). In a pooled analysis of seven available studies, patients treated with trastuzumab had less overall recurrence relative to controls, with an odds ratio of 0.201 [95% confidence interval (CI): 0.100–0.404, P<0.001]. Five studies were available for a pooled analysis of distant recurrence. Although the results were not significant (P=0.115), distant recurrence did not occur in 237 patients treated with trastuzumab, but did occur in 16 out of 436 control patients. The odds ratio for distant recurrence was 0.328 (95% CI: 0.082–1.311). CONCLUSIONS: The adjuvant treatment including trastuzumab was shown to reduce overall recurrence. Distant recurrence may also be reduced, as it did not occur among the 237 patients who underwent trastuzumab treatment. AME Publishing Company 2020-03 /pmc/articles/PMC7154451/ /pubmed/32309334 http://dx.doi.org/10.21037/atm.2020.01.81 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Lee, Hye Yoon
Shin, In-Soo
Rim, Chai Hong
Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis
title Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis
title_full Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis
title_fullStr Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis
title_full_unstemmed Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis
title_short Benefits of adjuvant treatment including trastuzumab in HER2-positive pT1a-bN0M0 breast cancer: a systematic review and meta-analysis
title_sort benefits of adjuvant treatment including trastuzumab in her2-positive pt1a-bn0m0 breast cancer: a systematic review and meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154451/
https://www.ncbi.nlm.nih.gov/pubmed/32309334
http://dx.doi.org/10.21037/atm.2020.01.81
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