Safety and efficacy of pyrotinib for HER‑2‑positive breast cancer in the neoadjuvant setting: A systematic review and meta‑analysis

Ma,Qian; Wei,Bai; Wang,Bi-Cheng; Wang,Ganxin; Zhou,Xuan; Wang,Yan

doi:10.3892/ol.2024.14325

Safety and efficacy of pyrotinib for HER‑2‑positive breast cancer in the neoadjuvant setting: A systematic review and meta‑analysis

Authors:
- Qian Ma
- Bai Wei
- Bi-Cheng Wang
- Ganxin Wang
- Xuan Zhou
- Yan Wang
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Affiliations: Department of Oncology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430077, P.R. China, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
Published online on: March 4, 2024 https://doi.org/10.3892/ol.2024.14325
Article Number: 192
Copyright: © Ma et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

As a novel tyrosine kinase inhibitor (TKI), pyrotinib can irreversibly block dual pan‑ErbB receptors and has been used in the treatment of advanced or metastatic human epidermal growth factor receptor 2 (HER2)‑positive breast cancer. However, there are limited data on the use of pyrotinib in early breast cancer. Therefore, the present meta‑analysis was conducted to evaluate the safety and efficacy of pyrotinib in the neoadjuvant setting for patients with early‑stage or locally advanced HER2‑positive breast cancer. Online databases (Pubmed, Web of Science, Embase and Cochrane Library) were comprehensively searched for eligible prospective clinical trials on August 17, 2023. The primary endpoint was the treatment‑related adverse events (TRAEs), and the secondary endpoint was pathological complete response (pCR) rate. In total, seven trials with a total enrolment of 407 patients were included. A total of seven studies evaluated pyrotinib in combination with trastuzumab and chemotherapy in the neoadjuvant setting. The median age ranged from 47‑50 years. The most common TRAEs were diarrhea [98% of patients; 95% confidence interval (CI): 92‑100%], followed by anemia (71%; 95% CI: 55‑89%), vomiting (69%; 95% CI: 55‑82%), and leucopenia (66%; 95% CI: 35‑91%). No treatment‑related deaths occurred. The pooled pCR rate was 57% (95% CI: 47‑68%). It was concluded that pyrotinib‑containing neoadjuvant therapy could be an effective treatment strategy in patients with early‑stage or locally advanced HER2‑positive breast cancer; however, the management of adverse events should be a key consideration. The management of adverse events should be paid great attention to, during pyrotinib therapy, although pyrotinib‑contained neoadjuvant therapy could be an effective treatment for patients with early‑stage or locally advanced HER2‑positive breast cancer. Head‑to‑head randomized clinical trials are warranted to further confirm the benefits and risks associated with pyrotinib therapy in patients with breast cancer.

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