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Trastuzumab treatment after progression in HER2-positive metastatic breast cancer following relapse of trastuzumab-based regimens: a meta-analysis

Authors Han Y, Wang J, Liu W, Yuan P, Li Q, Zhang P, Ma F, Luo Y, Fan Y, Chen S, Cai R, Li Q, Xu B

Received 20 December 2018

Accepted for publication 18 April 2019

Published 23 May 2019 Volume 2019:11 Pages 4699—4706


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo

Yiqun Han,1 Jiayu Wang,1 Weiming Liu,2 Peng Yuan,1 Qing Li,1 Pin Zhang,1 Fei Ma,1 Yang Luo,1 Ying Fan,1 Shanshan Chen,1 Ruigang Cai,1 Qiao Li,1 Binghe Xu1

1National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Critical Care Medicine, China Rehabilitation Research Center, Beijing, People’s Republic of China

Background: This meta-analysis assessed the safety and effectiveness of retreatment with trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (HER2+MBC).
Materials and methods: Randomized controlled trials (RCTs) and cohort studies that compared the clinical outcomes of continuation and termination of trastuzumab treatment in HER2+MBC after failure of trastuzumab-based regimens were analyzed. Pooled estimates of time to progression (TTP) survival, overall survival (OS), the incidence of adverse events and central nervous system (CNS) perturbations were determined.
Results: Four RCTs and six cohort studies with 2,409 patients were identified. The continuation of trastuzumab presented a statistical significance in prolonging TTP (HR 0.88; 95% CI: 0.82–0.94; P<0.000) and OS (HR 0.87; 95% CI: 0.82–0.93; P<0.000). Furthermore, retreatment with trastuzumab did not add to the risk of cardiac events (relative risk, 2.48; 95% CI: 0.86–7.15) or the incidence of CNS metastasis (P=0.83).
Conclusion: Our findings confirm the clinical benefits and safety of retreatment therapy with trastuzumab for HER2-positive patients with metastatic cancer of the breast that had progressed during trastuzumab-based treatment regimens.

Keywords: trastuzumab, retreatment, HER2-positive cancer, metastatic cancer of the breast, progression therapy

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