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. 2019 Aug 29:11:8043-8054.
doi: 10.2147/CMAR.S208319. eCollection 2019.

Do early HER2-overexpression breast cancer patients benefit from undergoing neoadjuvant trastuzumab and mastectomy? A meta-analysis

Lin He #  1 , Qian Wu #  1 , Jing Xiong  2 , Zhumin Su  3 , Biyuan Zhang  4 , Yuhua Song  1
Affiliations

Do early HER2-overexpression breast cancer patients benefit from undergoing neoadjuvant trastuzumab and mastectomy? A meta-analysis

Lin He et al. Cancer Manag Res. .

Abstract

Purpose: To assess the overall survival (OS) of early human epidermal growth factor receptor 2 (HER2)-enriched breast cancer patients after receiving neoadjuvant trastuzumab (NAT) compared to adjuvant trastuzumab (AT) treatment and the difference in local-regional relapse (LRR) rate with this tumor and treatment between women after mastectomy and women after breast-conserving therapy (BCT).

Methods: Articles were retrieved from PubMed, Embase, Web of Science, and Cochrane Library. A pooled odds ratio (OR) with a 95% confidential interval (CI) was calculated. The StataSE version 12.0 software was employed for meta-analysis.

Results: Twelve available clinical studies containing 2366 subjects were included. The OS of NAT compared with that of AT was not significantly different (pooled OR=1.04; 95% CI, 0.47-2.33). There was a significantly lower LRR rate for patients with mastectomy compared to those with BCT (pooled OR=0.58; 95% CI, 0.38-0.89); however, subgroup analysis revealed that the significant advantage of LRR for mastectomy compared to BCT was only represented in women without trastuzumab treatment (pooled OR=0.52; 95% CI, 0.31-0.88) compared to those who received trastuzumab treatment (pooled OR=0.71; 95% CI, 0.34-1.49).

Conclusion: Early stage HER2-overexpression breast cancer patients benefit with an equivalent OS from NAT treatment compared to AT. Patients who underwent mastectomy and BCT experienced a similar LRR rate if they received anti-HER2 targeted therapy of trastuzumab, but the LRR rate was discernibly reduced in patients who received mastectomy compared to BCT if they did not also receive trastuzumab treatment.

Keywords: breast cancer; breast conserving therapy; human epidermal growth factor receptor 2; mastectomy; trastuzumab.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The study selection procedure. Abbreviation: HER2, human epidermal growth factor receptor 2.
Figure 2
Figure 2
The comparison of overall survival between neoadjuvant trastuzumab and adjuvant trastuzumab. Abbreviations: NAT, neoadjuvant trastuzumab; AT, adjuvant trastuzumab.
Figure 3
Figure 3
The comparison of local-regional relapse between mastectomy and BCT. (A) Whole group analysis; (B) Subgroup analysis. Abbreviation: BCT, breast-conserving therapy.
Figure 4
Figure 4
The assessment of risk of bias by the new Cochrane tool. (A) The risk of bias summary; (B) The risk of bias graph.
None
See this image and copyright information in PMC

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