Is it safe to give anthracyclines concurrently with trastuzumab in neo-adjuvant or metastatic settings for HER2-positive breast cancer? A meta-analysis of randomized controlled trials

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• 作者：Feng Du (1)
  Peng Yuan (1)
  Wenjie Zhu (1)
  Jiayu Wang (1)
  Fei Ma (1)
  Ying Fan (1)
  Binghe Xu (1)
  
• 关键词：Breast cancer ; Cardiac toxicity ; Anthracyclines ; Trastuzumab
• 刊名：Medical Oncology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：31
• 期：12
• 全文大小：357 KB
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  15. Swain SM, Whal
• 作者单位：Feng Du (1)
  Peng Yuan (1)
  Wenjie Zhu (1)
  Jiayu Wang (1)
  Fei Ma (1)
  Ying Fan (1)
  Binghe Xu (1)
  
  1. Department of Medical Oncology, Cancer Hospital and Institute, Peking Union Medical College, Beijing, 100021, China
  
• ISSN：1559-131X

文摘

Concurrent use of anthracyclines and trastuzumab used to be avoided in the treatment of HER2-positive breast cancer due to the high risk of cardiac toxicity. However, several newly published studies challenged this view and demonstrated that concomitant use of the two agents significantly improved the clinical outcome without causing additional cardiac toxicity. This meta-analysis summarized available data to investigate the safety and efficacy of concurrent use of anthracyclines and trastuzumab. Eligible studies were identified through several search strategies and assessed for quality. Data were extracted from studies in terms of baseline characteristics and key statistics, which were utilized to calculate pooled effect size. Eight studies were included in the meta-analysis to evaluate the cardiac safety of concurrent use of anthracyclines and trastuzumab. It is demonstrated that concomitant administration was moderately associated with increased risk of cardiac-related adverse events (RR?=?1.97, 95?% CI 1.49-.60, P?P?=?0.01) as well as in palliative setting (RR?=?3.92, 95?% CI 2.11-.27, P?P?=?0.03). Concurrent use of anthracyclines and trastuzumab increased the risk of cardiac toxicity in both neo-adjuvant and metastatic settings, although moderately increased pCR rate as neo-adjuvant treatment.