Pertuzumab in HER2-positive breast cancer: a systematic review and meta-analysis of randomized controlled trials.
Hala Aboushawareb, Abdelrhman W Mohamed, Hamzah M Alghzawi et al.
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In 30 seconds
This systematic review and meta-analysis pooled 8 randomized controlled trials involving 8367 patients with HER2-positive breast cancer to assess pertuzumab-based regimens. Compared with control regimens, pertuzumab was associated with improved progression-free survival (HR 0.74; 95% CI 0.67-0.83) and overall survival, with the clearest overall-survival benefit in locally advanced or metastatic disease (HR = 0.71, 95% CI 0.65-0.77). The pooled overall-survival estimate in neoadjuvant or adjuvant settings was not significant. Neither any adverse events nor grade ≥ 3 adverse events differed significantly between groups.
Key findings
- In locally advanced or metastatic disease, pertuzumab-based regimens were associated with improved overall survival (HR = 0.71, 95% CI 0.65-0.77).
- Progression-free survival favored pertuzumab-based regimens (HR 0.74; 95% CI 0.67-0.83).
- In neoadjuvant or adjuvant settings, the pooled overall-survival estimate was not significant (HR = 0.81, 95% CI 0.22-3.04).
- There was no significant difference in any adverse events (RR = 1.01; 95% CI 0.99-1.02) or grade ≥ 3 adverse events (RR 0.99; 95% CI 0.86-1.13).
Why it matters
The findings distinguish the evidence by disease setting: survival benefits were clearest in locally advanced or metastatic HER2-positive breast cancer, while the estimate in neoadjuvant or adjuvant disease was inconclusive. The pooled safety results also provide context for weighing pertuzumab-based dual HER2 blockade, without indicating a significant increase in overall or severe adverse events in the included trials.
What to keep in mind
The pooled overall-survival estimate for neoadjuvant or adjuvant settings was imprecise, with a wide confidence interval (HR = 0.81, 95% CI 0.22-3.04).