The optimal neoadjuvant treatment strategy for HR+/HER2 + breast cancer: a network meta-analysis
2025

Best Treatment for HR+/HER2+ Breast Cancer

Sample size: 2809 publication Evidence: high

Author Information

Author(s): Liu Shiwei, Yu Miao, Mou Exian, Wang Meihua, Liu Shuanghua, Xia Li, Li Hui, Tang Hao, Feng Yajing, Yu Xin, Mi Kun, Wang Hao

Primary Institution: Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China

Hypothesis

What is the optimal neoadjuvant treatment strategy for HR+/HER2+ breast cancer?

Conclusion

Trastuzumab plus pertuzumab is the best neoadjuvant treatment for HR+/HER2+ breast cancer, with anthracycline-free carboplatin-containing chemotherapy also showing promise.

Supporting Evidence

  • 20 trials with 2809 patients were included in the primary pCR analysis.
  • HP+C demonstrated a significantly higher pCR rate compared to H+C.
  • H+TKI+C achieved a higher pCR rate than both H+C and L+C.
  • Anthracycline-free regimens showed a marginally higher pCR rate than anthracycline-containing regimens.
  • Pertuzumab with trastuzumab ranked first in EFS analysis.

Takeaway

Doctors found that a combination of two medicines, trastuzumab and pertuzumab, works best for treating a specific type of breast cancer before surgery.

Methodology

A systematic review and network meta-analysis of trials comparing neoadjuvant regimens for HR+/HER2+ breast cancer.

Potential Biases

One trial had a high overall risk of bias due to missing randomization; most trials had low risk.

Limitations

The EFS analysis included only five trials, limiting robustness, and safety analysis was not conducted due to insufficient data.

Participant Demographics

Included 2809 patients with HR+/HER2+ breast cancer.

Statistical Information

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/s41598-024-84039-2

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