Open Access

Efficacy, safety and administration timing of trastuzumab in human epidermal growth factor receptor 2 positive breast cancer patients: A meta‑analysis

  • Authors:
    • Yuan‑Yuan Chen
    • Lin‑Wei Wang
    • Fang‑Fang Chen
    • Bi‑Bo Wu
    • Bin Xiong
  • View Affiliations

  • Published online on: February 19, 2016     https://doi.org/10.3892/etm.2016.3095
  • Pages: 1721-1733
  • Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Trastuzumab has been demonstrated to be an effective treatment in patients with human epidermal growth factor receptor‑2 (HER‑2) positive breast cancer (BC); however, inconsistent results with regards to the long‑term survival benefits, safety and optimal administration timing of trastuzumab exist. The present meta‑analysis investigated these inconsistencies in patients with HER‑2 positive BC that received adjuvant or neoadjuvant trastuzumab. Computerized and manual searches were used to identify eligible randomized control trials (RCTs) to include in the analysis. Based on a fixed or random effects model, hazard and risk ratios were calculated and used to assess the survival advantages and risks of trastuzumab. A total of 14,546 patients from 13 RCTs were included in the analysis; 9 RCTs used an adjuvant setting and 4 RCTs used a neoadjuvant setting. Analysis of RCTs with an adjuvant setting demonstrated that treatment with trastuzumab and chemotherapy in patients with HER‑2 positive BC, in comparison with patients receiving chemotherapy alone, improved disease‑free survival, overall survival and overall response. However, a higher incidence of neutropenia (P<0.0001), leukopenia (P<0.0001), diarrhea (P=0.002), skin/nail change (P=0.02), left ventricular ejection fraction reduction (P=0.007) and congestive heart failure (P<0.00001) was observed. Notably, the incidence of mortality and cardiac toxicity following concurrent and weekly use of trastuzumab was significantly lower compared to treatment with trastuzumab sequentially and every 3 weeks, respectively. Additionally, trastuzumab improved the pathologic complete response with no additional toxicity in the neoadjuvant setting. The present meta‑analysis summarizes that trastuzumab is efficacious in patients with HER‑2 positive BC in adjuvant and neoadjuvant settings. Thus, concurrent and weekly administration of trastuzumab is preferable to treatment with trastuzumab sequentially and every 3 weeks. These findings should be considered when using trastuzumab in future clinical practice.
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May-2016
Volume 11 Issue 5

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Chen YY, Wang LW, Chen FF, Wu BB and Xiong B: Efficacy, safety and administration timing of trastuzumab in human epidermal growth factor receptor 2 positive breast cancer patients: A meta‑analysis. Exp Ther Med 11: 1721-1733, 2016.
APA
Chen, Y., Wang, L., Chen, F., Wu, B., & Xiong, B. (2016). Efficacy, safety and administration timing of trastuzumab in human epidermal growth factor receptor 2 positive breast cancer patients: A meta‑analysis. Experimental and Therapeutic Medicine, 11, 1721-1733. https://doi.org/10.3892/etm.2016.3095
MLA
Chen, Y., Wang, L., Chen, F., Wu, B., Xiong, B."Efficacy, safety and administration timing of trastuzumab in human epidermal growth factor receptor 2 positive breast cancer patients: A meta‑analysis". Experimental and Therapeutic Medicine 11.5 (2016): 1721-1733.
Chicago
Chen, Y., Wang, L., Chen, F., Wu, B., Xiong, B."Efficacy, safety and administration timing of trastuzumab in human epidermal growth factor receptor 2 positive breast cancer patients: A meta‑analysis". Experimental and Therapeutic Medicine 11, no. 5 (2016): 1721-1733. https://doi.org/10.3892/etm.2016.3095