Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis

Abstract Background Neoadjuvant targeted therapy has shown that improve pathologic complete response and facilitate breast-conserving surgery, but the difference between single-agent treatment or dual-HER2 blockade to the conversion of breast-conserving surgery has not been well described. Methods V...

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Main Authors: Manlu Cui, Juan Fu, Qiuyun Li
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-024-13052-5
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author Manlu Cui
Juan Fu
Qiuyun Li
author_facet Manlu Cui
Juan Fu
Qiuyun Li
author_sort Manlu Cui
collection DOAJ
description Abstract Background Neoadjuvant targeted therapy has shown that improve pathologic complete response and facilitate breast-conserving surgery, but the difference between single-agent treatment or dual-HER2 blockade to the conversion of breast-conserving surgery has not been well described. Methods Via the systematic literature search of PubMed, Web of Science and Cochrane Library databases, 5 eligible studies used to perform this meta-analysis, which was carried out using RevMan version 5.4. Results A total of 1306 patients from five randomized controlled trials were included in the analysis, revealing a significant increase in the conversion rate to breast-conserving surgery with neoadjuvant targeted therapy (OR 0.30, 95% CI 0.15–0.57; p = 0.0003). The odds ratio (OR) for single-agent treatment compared to dual-HER2 blockade was 1.04 (95% CI 0.73–1.48; p = 0.82). For pathological complete response (pCR), the OR for single-HER2 blockade versus dual-HER2 blockade was 0.43 (95% CI 0.34–0.55; p = 0.01), and for clinical response, it was 0.81 (95% CI 0.59–1.10; p = 0.17). The OR for serious adverse events between single-HER2 and dual-HER2 blockade was 0.72 (95% CI 0.55–0.95; p = 0.02). The risk ratio (RR) for pCR and the shift from mastectomy to BCS was 1.16 (95% CI 0.78–1.72; p = 0.47), while for clinical response and the shift from mastectomy to BCS, it was 2.40 (95% CI 1.44–4.01; p = 0.0008). Conclusion Neoadjuvant targeted treatment obviously promote the actual implementation rate of breast-conserving surgery, nevertheless, there was no statistically significant increase in single-agent treatment versus dual-HER2 blockade.
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spelling doaj-art-e19ae38d7f034fb29d395c95423ee06c2025-08-20T01:50:38ZengBMCBMC Cancer1471-24072024-10-012411810.1186/s12885-024-13052-5Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysisManlu Cui0Juan Fu1Qiuyun Li2Department of Breast Surgery, Guangxi Medical University Cancer HospitalDepartment of Breast Surgery, Guangxi Medical University Cancer HospitalDepartment of Breast Surgery, Guangxi Medical University Cancer HospitalAbstract Background Neoadjuvant targeted therapy has shown that improve pathologic complete response and facilitate breast-conserving surgery, but the difference between single-agent treatment or dual-HER2 blockade to the conversion of breast-conserving surgery has not been well described. Methods Via the systematic literature search of PubMed, Web of Science and Cochrane Library databases, 5 eligible studies used to perform this meta-analysis, which was carried out using RevMan version 5.4. Results A total of 1306 patients from five randomized controlled trials were included in the analysis, revealing a significant increase in the conversion rate to breast-conserving surgery with neoadjuvant targeted therapy (OR 0.30, 95% CI 0.15–0.57; p = 0.0003). The odds ratio (OR) for single-agent treatment compared to dual-HER2 blockade was 1.04 (95% CI 0.73–1.48; p = 0.82). For pathological complete response (pCR), the OR for single-HER2 blockade versus dual-HER2 blockade was 0.43 (95% CI 0.34–0.55; p = 0.01), and for clinical response, it was 0.81 (95% CI 0.59–1.10; p = 0.17). The OR for serious adverse events between single-HER2 and dual-HER2 blockade was 0.72 (95% CI 0.55–0.95; p = 0.02). The risk ratio (RR) for pCR and the shift from mastectomy to BCS was 1.16 (95% CI 0.78–1.72; p = 0.47), while for clinical response and the shift from mastectomy to BCS, it was 2.40 (95% CI 1.44–4.01; p = 0.0008). Conclusion Neoadjuvant targeted treatment obviously promote the actual implementation rate of breast-conserving surgery, nevertheless, there was no statistically significant increase in single-agent treatment versus dual-HER2 blockade.https://doi.org/10.1186/s12885-024-13052-5Breast cancerNeoadjuvantTargeted therapyDual-HER2 blockadeBreast-conserving surgeryPathologic complete response
spellingShingle Manlu Cui
Juan Fu
Qiuyun Li
Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis
BMC Cancer
Breast cancer
Neoadjuvant
Targeted therapy
Dual-HER2 blockade
Breast-conserving surgery
Pathologic complete response
title Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis
title_full Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis
title_fullStr Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis
title_full_unstemmed Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis
title_short Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis
title_sort comparison of neoadjuvant single agent treatment and dual her2 blockade for breast conserving surgery conversion in her2 positive breast cancer a meta analysis
topic Breast cancer
Neoadjuvant
Targeted therapy
Dual-HER2 blockade
Breast-conserving surgery
Pathologic complete response
url https://doi.org/10.1186/s12885-024-13052-5
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AT qiuyunli comparisonofneoadjuvantsingleagenttreatmentanddualher2blockadeforbreastconservingsurgeryconversioninher2positivebreastcancerametaanalysis