PMID- 34012912
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220423
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 11
DP  - 2021
TI  - Efficacy and Safety of Pyrotinib Versus T-DM1 in HER2+ Metastatic Breast Cancer 
      Patients Pre-Treated With Trastuzumab and a Taxane: A Bayesian Network 
      Meta-Analysis.
PG  - 608781
LID - 10.3389/fonc.2021.608781 [doi]
LID - 608781
AB  - PURPOSE: To compare the efficacy and safety between pyrotinib (Pyr) and 
      trastuzumab emtansine (T-DM1) in pre-treated human epidermal growth factor 
      receptor 2-positive (HER2+) metastatic breast cancer (MBC) patients. METHODS: A 
      comprehensive literature search of the PubMed, EMBASE, and Web of Science was 
      performed in August 2020. Randomized clinical trials comparing the efficacy and 
      safety between different anti-HER2 regimens in patients pre-treated with 
      trastuzumab (Tra) and a taxane in metastatic settings (</=second-line treatment) 
      were included. A fixed effects network meta-analysis based on the Bayesian 
      inferential framework was conducted for progression-free survival (PFS), overall 
      survival (OS), overall response rate (ORR), and grade >/=3 adverse events (AEs). 
      Values of surface under cumulative ranking probability curve (SUCRA) were 
      calculated to offer a ranking of all regimens. RESULTS: Twelve studies with 4,353 
      subjects were identified. Nine regimens were included into the network: T-DM1, 
      lapatinib-capecitabine (Lap-Cap), Tra-Cap, Cap, neratinib (Ner), pertuzumab 
      (Per)-Tra-Cap, Pyr-Cap, atezolizumab (Ate)-T-DM1, and Ner-Cap. For PFS, Pyr-Cap 
      was more favorable than T-DM1 (hazard ratio, 95% confidence interval: 0.77, 
      0.70-0.86), Lap-Cap (0.64, 0.59-0.69), Tra-Cap (0.63, 0.56-0.70), Cap (0.50, 
      0.45-0.56), Ner (0.59, 0.51-0.69), Per-Tra-Cap (0.68, 0.59-0.79), and Ner-Cap 
      (0.72, 0.64-0.81). For OS, Pyr-Cap showed further improvement than Lap-Cap 
      (hazard ratio, 95% confidence interval: 0.71, 0.52-0.99), Cap (0.68, 0.49-0.96), 
      and Ner (0.65, 0.45-0.94). For ORR, Pyr-Cap was significantly superior than Cap 
      (odds ratio, 95% confidence interval: 7.87, 1.22-56.51). No significant 
      difference was observed in grade >/=3 AEs among all the regimens. Pyr-Cap ranked in 
      the highest in PFS, OS, ORR, and grade >/=3 AEs (SUCRA = 99.4, 89.7, 86.4, and 
      89.3%). CONCLUSIONS: These results indicate that Pyr may be more effective than 
      T-DM1 in HER2+ MBC patients pre-treated with Tra and a taxane. However, it may be 
      associated with more grade >/=3 AEs.
CI  - Copyright (c) 2021 Liao, Huang, Liu, Pei and Li.
FAU - Liao, Hao
AU  - Liao H
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Breast Oncology, Peking University Cancer 
      Hospital and Institute, Beijing, China.
FAU - Huang, Wenfa
AU  - Huang W
AD  - Department of Hematology-Oncology, International Cancer Center, Shenzhen 
      University General Hospital, Shenzhen University Health Science Center, Shenzhen, 
      China.
FAU - Liu, Yaxin
AU  - Liu Y
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Breast Oncology, Peking University Cancer 
      Hospital and Institute, Beijing, China.
FAU - Pei, Wendi
AU  - Pei W
AD  - Center for Reproductive Medicine, Department of Obstetrics and Gynecology, 
      Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive 
      Technology and Key Laboratory of Assisted Reproduction, Ministry of Education, 
      Peking University Third Hospital, Beijing, China.
FAU - Li, Huiping
AU  - Li H
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Breast Oncology, Peking University Cancer 
      Hospital and Institute, Beijing, China.
LA  - eng
PT  - Systematic Review
DEP - 20210503
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC8127838
OTO - NOTNLM
OT  - human epidermal growth factor
OT  - metastatic breast cancer
OT  - network meta-analysis
OT  - pyrotinib
OT  - trastuzumab emtansine
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/05/21 06:00
MHDA- 2021/05/21 06:01
PMCR- 2021/01/01
CRDT- 2021/05/20 06:45
PHST- 2020/09/21 00:00 [received]
PHST- 2021/04/06 00:00 [accepted]
PHST- 2021/05/20 06:45 [entrez]
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2021/05/21 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2021.608781 [doi]
PST - epublish
SO  - Front Oncol. 2021 May 3;11:608781. doi: 10.3389/fonc.2021.608781. eCollection 
      2021.