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The clinical benefit of epidermal growth factor receptor and human epidermal growth factor receptor 2 targeted agents adding to endocrine therapy in hormone receptor-positive breast cancer


 Department of Pharmacy, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Correspondence Address:
Bo Yu,
Department of Pharmacy, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai 200032
China
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Source of Support: None, Conflict of Interest: None

Objectives: Studies have suggested that the crosstalk between estrogen receptor and ErbB receptor is involved in endocrine therapy (ET) resistance, which might be overcome by drugs-targeting ErbB receptor. However, the results of clinical studies remain controversial. The aim of this meta-analysis was to evaluate the efficacy and safety of ErbB (mainly epidermal growth factor receptor and human epidermal growth factor receptor 2 [HER2]) inhibitors added to ET for hormone receptor-positive breast cancer patients. Materials and Methods: Eligible randomized clinical trials on ET with or without ErbB receptor-targeting inhibitors (ERTI) for hormone receptor-positive breast cancer were identified by searching the main electronic databases (up to July 2015). Revman 5.3 was used to analyze the outcomes extracted from the included trials. Results: In the overall population, ERTI failed to show any significant differences on overall response rate (ORR), clinical benefit rate (CBR), and overall survival (OS). However, improvement on progression-free survival (PFS) (hazard ratio [HR] 0.84, 95% confidence interval [CI] = 0.76–0.93, P = 0.0005) was observed. For the HER2+ subgroup, ERTI could significantly improve ORR, CBR, PFS, OS, and time to progression compared to endocrine monotherapy. This improvement cannot be found in the HER2− subgroup. The risk of serious adverse events (SAEs) increased significantly when ERTI was present (RR = 2.09, 95% CI = 1.44–3.02, P < 0.0001). Conclusions: For HR+/HER2+ breast cancer, ERTI added to ET can significantly improve the clinical efficacy with the cost of increasing SAE.


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    -  Li H
    -  Zhai Q
    -  Yu B
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