Impact of neoadjuvant single or dual HER2 inhibition and chemotherapy backbone upon pathological complete response in operable and locally advanced breast cancer: Sensitivity analysis of randomized trials

Emilio Bria, Luisa Carbognin, Jenny Furlanetto, Sara Pilotto, Maria Bonomi, Valentina Guarneri, Cecilia Vicentini, Matteo Brunelli, Rolando Nortilli, Francesca Pellini, Isabella Sperduti, Diana Giannarelli, Giovanni Paolo Pollini, Pierfranco Conte, Giampaolo Tortora

Research output: Contribution to journalArticlepeer-review

Abstract

The role of the dual HER2 inhibition, and the best chemotherapy backbone for neoadjuvant chemotherapy still represent an issue for clinical practice.A literature-based meta-analysis exploring single versus dual HER2 inhibition in terms of pathological complete response (pCR, breast plus axilla) rate and testing the interaction according to the chemotherapy (anthracyclines-taxanes or taxanes) was conducted. In addition, an event-based pooled analysis by extracting activity and safety events and deriving 95% confidence intervals (CI) was accomplished.Fourteen trials (4149 patients) were identified, with 6 trials (1820 patients) included in the meta-analysis and 31 arms (14 trials, 3580 patients) in the event-based pooled analysis. The dual HER2 inhibition significantly improves pCR rate, in the range of 16-19%, regardless of the chemotherapy backbone (relative risk 1.37, 95% CI 1.23-1.53, p

Original languageEnglish
Pages (from-to)847-856
Number of pages10
JournalCancer Treatment Reviews
Volume40
Issue number7
DOIs
Publication statusPublished - 2014

Keywords

  • Breast cancer
  • HER2-positive
  • Meta-analysis
  • Neoadjuvant
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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