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      Meta-Analysis of HER2-Enriched Subtype Predicting the Pathological Complete Response Within HER2-Positive Breast Cancer in Patients Who Received Neoadjuvant Treatment

      systematic-review

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          Abstract

          Background

          This meta-analysis aimed to better elucidate the predictive value of human epidermal growth factor receptor 2 (HER2)-enriched subtype of pathological complete response (pCR) rate within HER2-positive breast cancer patients receiving neoadjuvant treatment.

          Methods

          We identified prospective trials that evaluated the correlation between an HER2-enriched subtype and pCR rate in HER2-positive breast cancer. Pooled odds ratio (OR) values with 95% confidence intervals (CIs) were computed.

          Results

          Fifteen studies comprising 2,190 patients met the inclusion criteria. The HER2-enriched subtype was associated with increased odds of achieving a pCR (OR = 4.12, 95% CI = 3.38 to 5.03, P < 0.001) in patients overall. Moreover, it was correlated with improved pCR when single or dual HER2-targeted agent-based therapy was employed (OR = 3.36, 95% CI = 2.25 to 5.02, P < 0.001; OR = 4.66, 95% CI = 3.56 to 6.10, P < 0.001, respectively), but not when HER2-targeted agent-free chemotherapy was used (OR = 2.52, 95% CI = 0.98 to 6.49, P = 0.05). Moreover, an HER2-enriched subtype predicted higher pCR rates irrespective of HER2-targeted agents (trastuzumab, lapatinib, pertuzumab, or T-DM1); chemotherapy agents (taxane-based, or anthracyclines plus taxane-based); endocrine therapy and hormone receptor [all the differences were statistically significant ( P all ≤ 0.001)].

          Conclusions

          The HER2-enriched subtype can more effectively and specifically predict pCR for HER2-targeted agent-based neoadjuvant treatment, irrespective of the number (single or dual) or category of HER2-targeted agent, including chemotherapy and endocrine therapy, or hormone receptor in cases of HER2-positive breast cancer.

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          Most cited references48

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          The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

          Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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            Bias in meta-analysis detected by a simple, graphical test

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              Meta-analysis in clinical trials

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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                23 July 2021
                2021
                : 11
                : 632357
                Affiliations
                [1] 1 Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University , Xining, China
                [2] 2 Key Laboratory of Carcinogenesis and Translational Research, The VIPII Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute , Beijing, China
                [3] 3 Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing, China
                Author notes

                Edited by: Sofia Diana Merajver, University of Michigan, United States

                Reviewed by: Cheryl Lynn Jorcyk, Boise State University, United States; Silvia Soddu, Regina Elena National Cancer Institute (IRCCS), Italy

                *Correspondence: Jiuda Zhao, jiudazhao@ 123456126.com

                This article was submitted to Cancer Molecular Targets and Therapeutics, a section of the journal Frontiers in Oncology

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fonc.2021.632357
                8343531
                34367947
                9351bf38-ce42-4580-9858-048ed95033f9
                Copyright © 2021 Shen, Zhao, Huo, Ren, Du, Zheng and Zhao

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 23 November 2020
                : 02 July 2021
                Page count
                Figures: 6, Tables: 1, Equations: 0, References: 49, Pages: 13, Words: 6615
                Categories
                Oncology
                Systematic Review

                Oncology & Radiotherapy
                human epidermal growth factor receptor 2 (her2)-enriched subtype,her2-postive breast cancer,neoadjuvant treatment,pathologic complete response,meta-analysis

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