Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis
Abstract 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 fo...
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doaj-2049197d1bce4940b7868242ed6624262020-11-24T21:18:39ZengBMCSystematic Reviews2046-40532018-11-017111710.1186/s13643-018-0854-yHerceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysisFlorence R. Wilson0Megan E. Coombes1Christine Brezden-Masley2Mariya Yurchenko3Quinlan Wylie4Reuben Douma5Abhishek Varu6Brian Hutton7Becky Skidmore8Chris Cameron9Cornerstone Research Group Inc.Hoffmann-La Roche LimitedSt. Michael’s HospitalHoffmann-La Roche LimitedCornerstone Research Group Inc.Cornerstone Research Group Inc.Cornerstone Research Group Inc.Ottawa Hospital Research InstituteIndependent Information SpecialistCornerstone Research Group Inc.Abstract 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 CRD42017055763http://link.springer.com/article/10.1186/s13643-018-0854-yEarly breast cancerHER2-positive breast cancerNetwork meta-analysisSurvivalSystematic reviewTrastuzumab |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Florence R. Wilson Megan E. Coombes Christine Brezden-Masley Mariya Yurchenko Quinlan Wylie Reuben Douma Abhishek Varu Brian Hutton Becky Skidmore Chris Cameron |
spellingShingle |
Florence R. Wilson Megan E. Coombes Christine Brezden-Masley Mariya Yurchenko Quinlan Wylie Reuben Douma Abhishek Varu Brian Hutton Becky Skidmore Chris Cameron Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis Systematic Reviews Early breast cancer HER2-positive breast cancer Network meta-analysis Survival Systematic review Trastuzumab |
author_facet |
Florence R. Wilson Megan E. Coombes Christine Brezden-Masley Mariya Yurchenko Quinlan Wylie Reuben Douma Abhishek Varu Brian Hutton Becky Skidmore Chris Cameron |
author_sort |
Florence R. Wilson |
title |
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_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_sort |
herceptin® (trastuzumab) in her2-positive early breast cancer: a systematic review and cumulative network meta-analysis |
publisher |
BMC |
series |
Systematic Reviews |
issn |
2046-4053 |
publishDate |
2018-11-01 |
description |
Abstract 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 |
topic |
Early breast cancer HER2-positive breast cancer Network meta-analysis Survival Systematic review Trastuzumab |
url |
http://link.springer.com/article/10.1186/s13643-018-0854-y |
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