联合曲妥珠单抗的新辅助化疗方案用于HER2阳性乳腺癌的Meta分析

A meta-analysis of neoadjuvant chemotherapy combined with trastuzumab for HER2-positive breast cancers

目的评价联合曲妥珠单抗的新辅助化疗用于HER2阳性乳腺癌的疗效及安全性。方法检索2000～2009年3月PUBMED在线数据库、ASCO、SABCS、ESMO会议论文数据库以及中国生物医学光盘数据库中有关曲妥珠单抗用于乳腺癌新辅助化疗的文献。对符合入选标准的文献进行质量评价与Meta分析。结果共有3个研究纳入分析。与单纯化疗相比,联合曲妥珠单抗的化疗方案可以大幅度提高HER2阳性乳腺癌患者的病理完全缓解率(合并RR值为1.65,95%CI1.28～2.13,P<0.0001),同时联合组的心脏毒性并未明显增加(合并RR值为1.16,95%CI0.82～1.64,P=0.41)。结论在HER2阳性乳腺癌的新辅助化疗中,联合曲妥珠单抗的化疗方案明显优于单纯化疗方案。

Objective To evaluate the efficacy and safety of neoadjuvant chemotherapy combined with trastuzumab for HER2 positive breast cancers. Methods PubMed online database, ASCO abstract database, SABCS abstract database, ESMO abstract database and CBMdisc database were searched for literatures related to trastuzumab in neoadjuvant chemotherapy for breast cancers. A meta-analysis was performed for retrieved literatures meeting the inclusion criteria. Results Three clinical trials were included. Meta-analysis showed that compared to chemotherapy only, regimens combined with trastuzumab could significantly improved the pCR rate of HER2-positive breast cancers （RR=1.65, 95% CI 1.28-2.13, P〈0.0001 ）without increasing the frequencies of cardiac toxicity （RR=I.16, 95% CI 0.82-1.64, P=0.41）. Conclusion In neoadjuvant chemotherapy for HER2-positive breast cancers, chemotherapy combined with trastuzumab is superior to exclusive chemotherapy.