PMID- 37255389
OWN - NLM
STAT- MEDLINE
DCOM- 20230814
LR  - 20231213
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 12
IP  - 14
DP  - 2023 Jul
TI  - Tyrosine kinase inhibitors in HER2-positive breast cancer brain metastases: A 
      systematic review and meta-analysis.
PG  - 15090-15100
LID - 10.1002/cam4.6180 [doi]
AB  - BACKGROUND: Small tyrosine kinase inhibitors (TKIs) show activity against breast 
      cancer brain metastases (BCBM) of the human epidermal growth factor receptor 2 
      (HER2)-positive subtype. This meta-analysis aimed to objectively explore the 
      efficacy and safety of TKIs. METHODS: Electronic databases were searched for 
      relevant clinical trials. We conducted a pairwise meta-analysis, pooled analysis, 
      and estimated summary survival curves to compare survival outcomes following TKIs 
      therapy for BCBM patients using Stata version 16.0 or R x64 4.0.5. RESULTS: 
      Thirteen clinical trials involving 987 HER2-positive BCBM patients were analyzed. 
      A trend of longer progression-free survival (PFS) was observed in the 
      TKI-containing arm compared to the non-TKI-containing arm (hazard ratio = 0.64, 
      95% confidence interval [CI]: 0.35-1.15, p = 0.132), although the difference is 
      not statistically significant. Summary survival curves reported the summary 
      median PFS and overall survival were 7.9 months and 12.3 months. Subgroup 
      analysis revealed that TKIs combined with capecitabine (TKI + Cap) regimens 
      resulted in improved survival outcomes. Tucatinib may be more effective in BCBM 
      patients. The main grade 3-5 adverse events (AEs) were diarrhea (22%, 95% CI: 
      14%-32%), neutropenia (11%, 95% CI: 5%-18%), hepatic toxicity (7%, 95% CI: 
      1%-16%), and sensory neuropathy (6%, 95% CI: 2%-12%). CONCLUSION: TKIs therapy 
      improved the survival outcomes of HER2-positive BCBM patients, especially when 
      combined with capecitabine and tolerable AEs. We also identified the clinical 
      value of tucatinib, which appears to be the most favorable TKI drug for BCBM 
      patients.
CI  - (c) 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Yu, Yushuai
AU  - Yu Y
AD  - Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
AD  - Breast Cancer Institute, Fujian Medical University, Fuzhou, China.
FAU - Huang, Kaiyan
AU  - Huang K
AD  - Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
AD  - Breast Cancer Institute, Fujian Medical University, Fuzhou, China.
FAU - Lin, Yuxiang
AU  - Lin Y
AD  - Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
AD  - Breast Cancer Institute, Fujian Medical University, Fuzhou, China.
AD  - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
FAU - Zhang, Jie
AU  - Zhang J
AD  - Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
AD  - Breast Cancer Institute, Fujian Medical University, Fuzhou, China.
AD  - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
FAU - Song, Chuangui
AU  - Song C
AUID- ORCID: 0000-0001-5703-9123
AD  - Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
AD  - Breast Cancer Institute, Fujian Medical University, Fuzhou, China.
AD  - Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 
      China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230531
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 6804DJ8Z9U (Capecitabine)
RN  - 0 (Tyrosine Kinase Inhibitors)
RN  - 0 (Protein Kinase Inhibitors)
SB  - IM
MH  - Humans
MH  - Female
MH  - *Breast Neoplasms/pathology
MH  - Capecitabine/therapeutic use
MH  - Tyrosine Kinase Inhibitors
MH  - *Brain Neoplasms/drug therapy/secondary
MH  - Progression-Free Survival
MH  - Protein Kinase Inhibitors/adverse effects
PMC - PMC10417165
OTO - NOTNLM
OT  - Brain metastases
OT  - HER2-positive
OT  - breast cancer
OT  - meta-analysis
OT  - small-molecule tyrosine kinase inhibitors
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/05/31 13:12
MHDA- 2023/08/14 06:42
PMCR- 2023/05/31
CRDT- 2023/05/31 09:45
PHST- 2023/05/04 00:00 [revised]
PHST- 2022/05/23 00:00 [received]
PHST- 2023/05/20 00:00 [accepted]
PHST- 2023/08/14 06:42 [medline]
PHST- 2023/05/31 13:12 [pubmed]
PHST- 2023/05/31 09:45 [entrez]
PHST- 2023/05/31 00:00 [pmc-release]
AID - CAM46180 [pii]
AID - 10.1002/cam4.6180 [doi]
PST - ppublish
SO  - Cancer Med. 2023 Jul;12(14):15090-15100. doi: 10.1002/cam4.6180. Epub 2023 May 
      31.