PMID- 36890831
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230310
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 13
DP  - 2023
TI  - Treatment options for patients with human epidermal growth factor 2-positive 
      breast cancer brain metastases: A systematic review and meta-analysis.
PG  - 1003565
LID - 10.3389/fonc.2023.1003565 [doi]
LID - 1003565
AB  - INTRODUCTION: Many systemic treatment options are available for patients with 
      human epidermal growth factor 2 (HER2)-positive breast cancer brain metastases. 
      However, it is unclear which pharmacological treatment option is the most 
      beneficial. METHODS: We searched databases, such as PubMed, Embase, and Cochrane 
      Library, and conference abstracts according to keywords. We extracted 
      progression-free survival (PFS), overall survival (OS) data, and overall response 
      rate (ORR) from randomized controlled trials and single-arm studies of 
      HER2-positive breast cancer brain metastasis treatment for meta-analysis and 
      analyzed different drug-related adverse events (AEs). RESULTS: Three randomized 
      controlled trials and seven single-arm clinical studies with 731 patients with 
      HER2-positive brain metastases from breast cancer involving at least seven drugs 
      were included. In randomized controlled trials, our results showed that 
      trastuzumab deruxtecan significantly improved PFS and OS in patients and was 
      superior to other drug regimens. In the single-arm study, the ORR was more 
      pronounced for the trastuzumab deruxtecan and pyrotinib plus capecitabine 
      regimens (ORR, 73.33%; 95% confidence intervals [CI], 44.90%-92.21%; ORR, 74.58%; 
      95% CI, 61.56%-85.02%, respectively). We found that the main AEs of antibody-drug 
      conjugate (ADC) were nausea and fatigue, while the main AE of small-molecule 
      tyrosine kinase inhibitor (TKI) drugs and large monoclonal antibodies was 
      diarrhea. CONCLUSIONS: Trastuzumab deruxtecan was shown to be the most 
      significant in improving survival in patients with HER2-positive breast cancer 
      brain metastases in network meta-analysis, and in single-arm study, patients with 
      HER2-positive breast cancer brain metastases treated with trastuzumab deruxtecan 
      and pyrotinib plus capecitabine regimen had the highest ORR. The main AEs 
      associated with ADC, large monoclonal antibodies, and TKI drugs were nausea, 
      fatigue, and diarrhea, respectively.
CI  - Copyright (c) 2023 Huo, Shen, Wang, Li, Xie, Liu, Wang, Zhao, Ren and Zhao.
FAU - Huo, Xingfa
AU  - Huo X
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
AD  - Precision Medicine Center of Oncology, The Affiliated Hospital of Qingdao 
      University, Qingdao, Shandong, China.
FAU - Shen, Guoshuang
AU  - Shen G
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Wang, Tianzhuo
AU  - Wang T
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Li, Jinming
AU  - Li J
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Xie, Qiqi
AU  - Xie Q
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Liu, Zhen
AU  - Liu Z
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Wang, Miaozhou
AU  - Wang M
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Zhao, Fuxing
AU  - Zhao F
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Ren, Dengfeng
AU  - Ren D
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
FAU - Zhao, Jiuda
AU  - Zhao J
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
LA  - eng
PT  - Systematic Review
DEP - 20230220
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9986525
OTO - NOTNLM
OT  - HER2
OT  - brain metastases
OT  - breast cancer
OT  - meta-analysis
OT  - treatment
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- 2023/03/10 06:00
MHDA- 2023/03/10 06:01
PMCR- 2023/01/01
CRDT- 2023/03/09 02:05
PHST- 2022/07/26 00:00 [received]
PHST- 2023/02/08 00:00 [accepted]
PHST- 2023/03/09 02:05 [entrez]
PHST- 2023/03/10 06:00 [pubmed]
PHST- 2023/03/10 06:01 [medline]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2023.1003565 [doi]
PST - epublish
SO  - Front Oncol. 2023 Feb 20;13:1003565. doi: 10.3389/fonc.2023.1003565. eCollection 
      2023.