The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis
Abstract The efficacy of neoadjuvant therapy varies significantly with hormone receptor (HR) status for patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer (BC). Despite extensive research on HER2 + BC, the optimal neoadjuvant strategy for HR+/HER2 + BC remains incon...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-84039-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559621065506816 |
|---|---|
| author | Shiwei Liu Miao Yu Exian Mou Meihua Wang Shuanghua Liu Li Xia Hui Li Hao Tang Yajing Feng Xin Yu Kun Mi Hao Wang |
| author_facet | Shiwei Liu Miao Yu Exian Mou Meihua Wang Shuanghua Liu Li Xia Hui Li Hao Tang Yajing Feng Xin Yu Kun Mi Hao Wang |
| author_sort | Shiwei Liu |
| collection | DOAJ |
| description | Abstract The efficacy of neoadjuvant therapy varies significantly with hormone receptor (HR) status for patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer (BC). Despite extensive research on HER2 + BC, the optimal neoadjuvant strategy for HR+/HER2 + BC remains inconclusive. This study aimed to identify the optimal neoadjuvant regimen for HR+/HER2 + BC treatment. We conducted a systematic search for trials comparing neoadjuvant regimens for HR+/HER2 + BC and a network meta-analysis. Odds ratios for pathological complete response (pCR) and hazard ratios for event-free survival (EFS) were calculated. Treatment regimens were ranked using the surface under the cumulative ranking curve. 20 trials with 2809 patients were included. In pCR analysis, three neoadjuvant regimens sequentially ranked at the top, namely those comprising T-DM1, pertuzumab with trastuzumab, and tyrosine kinase inhibitor with trastuzumab, demonstrating significantly higher pCR rates than monotherapies. In EFS analysis, pertuzumab with trastuzumab ranked the first while T-DM1 containing regimen ranked the last. Anthracycline-free regimens showed a marginally higher pCR rate than anthracycline-containing regimens, while carboplatin-containing regimens demonstrated a numerically higher pCR rate than carboplatin-free regimens. Significant heterogeneity was observed in endocrine therapy analysis, which may be caused by different strategies for incorporating endocrine therapy. In conclusion, trastuzumab plus pertuzumab stands out as the optimal neoadjuvant HER2-targeting regimen for HR+/HER2 + BC Furthermore, anthracycline-free carboplatin-containing chemotherapy emerges as a promising combination treatment. Further investigation is required to clarify the role of endocrine therapy in HR+/HER2 + BC to guide its clinical application. |
| format | Article |
| id | doaj-art-bdb3523baad6428698c5043bbb580f95 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-bdb3523baad6428698c5043bbb580f952025-01-05T12:22:29ZengNature PortfolioScientific Reports2045-23222025-01-0115111610.1038/s41598-024-84039-2The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysisShiwei Liu0Miao Yu1Exian Mou2Meihua Wang3Shuanghua Liu4Li Xia5Hui Li6Hao Tang7Yajing Feng8Xin Yu9Kun Mi10Hao Wang11Department of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaShanghai Roche Pharmaceuticals LtdShanghai Roche Pharmaceuticals LtdShanghai Roche Pharmaceuticals LtdRadiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaAbstract The efficacy of neoadjuvant therapy varies significantly with hormone receptor (HR) status for patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer (BC). Despite extensive research on HER2 + BC, the optimal neoadjuvant strategy for HR+/HER2 + BC remains inconclusive. This study aimed to identify the optimal neoadjuvant regimen for HR+/HER2 + BC treatment. We conducted a systematic search for trials comparing neoadjuvant regimens for HR+/HER2 + BC and a network meta-analysis. Odds ratios for pathological complete response (pCR) and hazard ratios for event-free survival (EFS) were calculated. Treatment regimens were ranked using the surface under the cumulative ranking curve. 20 trials with 2809 patients were included. In pCR analysis, three neoadjuvant regimens sequentially ranked at the top, namely those comprising T-DM1, pertuzumab with trastuzumab, and tyrosine kinase inhibitor with trastuzumab, demonstrating significantly higher pCR rates than monotherapies. In EFS analysis, pertuzumab with trastuzumab ranked the first while T-DM1 containing regimen ranked the last. Anthracycline-free regimens showed a marginally higher pCR rate than anthracycline-containing regimens, while carboplatin-containing regimens demonstrated a numerically higher pCR rate than carboplatin-free regimens. Significant heterogeneity was observed in endocrine therapy analysis, which may be caused by different strategies for incorporating endocrine therapy. In conclusion, trastuzumab plus pertuzumab stands out as the optimal neoadjuvant HER2-targeting regimen for HR+/HER2 + BC Furthermore, anthracycline-free carboplatin-containing chemotherapy emerges as a promising combination treatment. Further investigation is required to clarify the role of endocrine therapy in HR+/HER2 + BC to guide its clinical application.https://doi.org/10.1038/s41598-024-84039-2Breast cancerHER2 positiveHR positiveNeoadjuvant therapyTargeted therapyNetwork meta-analysis |
| spellingShingle | Shiwei Liu Miao Yu Exian Mou Meihua Wang Shuanghua Liu Li Xia Hui Li Hao Tang Yajing Feng Xin Yu Kun Mi Hao Wang The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis Scientific Reports Breast cancer HER2 positive HR positive Neoadjuvant therapy Targeted therapy Network meta-analysis |
| title | The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis |
| title_full | The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis |
| title_fullStr | The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis |
| title_full_unstemmed | The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis |
| title_short | The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis |
| title_sort | optimal neoadjuvant treatment strategy for hr her2 breast cancer a network meta analysis |
| topic | Breast cancer HER2 positive HR positive Neoadjuvant therapy Targeted therapy Network meta-analysis |
| url | https://doi.org/10.1038/s41598-024-84039-2 |
| work_keys_str_mv | AT shiweiliu theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT miaoyu theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT exianmou theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT meihuawang theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT shuanghualiu theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT lixia theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT huili theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT haotang theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT yajingfeng theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT xinyu theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT kunmi theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT haowang theoptimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT shiweiliu optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT miaoyu optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT exianmou optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT meihuawang optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT shuanghualiu optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT lixia optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT huili optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT haotang optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT yajingfeng optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT xinyu optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT kunmi optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis AT haowang optimalneoadjuvanttreatmentstrategyforhrher2breastcanceranetworkmetaanalysis |