Evidence map›Paper›PMID 38808848›Full record

SynthesisRevista peruana de medicina experimental y salud publica2024

Trastuzumab-emtansine versus other anti-HER2 regimens in early or unresectable or metastatic HER-2 positive breast cancer: systematic review and network meta-analysis.

Agustín Ciapponi, Ariel Bardach, Carla Colaci, Federico Rodríguez Cairoli, Fernando Argento, Ernesto Korbenfeld, Sebastián García Martí

Abstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
In one paragraph

Synthesis in Revista peruana de medicina experimental y salud publica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Agustín CiapponiInstituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0001-5142-6122
Ariel BardachInstituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0003-4437-0073
Carla ColaciInstituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0002-5397-7531
Federico Rodríguez CairoliInstituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0002-3029-4439
Fernando ArgentoInstituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0002-2492-8933
Ernesto KorbenfeldHospital Británico de Buenos Aires, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0001-6343-9991
Sebastián García MartíInstituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0003-3274-7275

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

OBJECTIVE.: Motivation for the study. Treatment options for HER2-positive breast cancer were evaluated, focusing on the efficacy and safety of trastuzumab-emtansine (T-DM1) compared to other anti-HER2 therapies. Main findings. Trastuzumab-deruxtecan (T-DXd) and PyroCap emerged as promising alternatives, showing substantial improvements in progression-free survival for locally advanced or metastatic breast cancer. T-DM1 showed superior efficacy to the other treatments. Implications. Our findings could inform healthcare decision-making processes to optimize strategies for HER2-positive breast cancer, and potentially improve health outcomes and quality of life. We aimed to study the efficacy and safety of trastuzumab-emtansine (T-DM1) versus other anti-HER2 therapies in HER2+ breast cancer (BC). MATERIALS AND METHODS.: We performed a network meta-analysis (NMA) of randomized controlled trials (RCTs). Our study focused on patients undergoing treatment for unresectable locally advanced breast cancer (LABC) or metastatic breast cancer (mBC), which included regimens involving trastuzumab and taxanes. Additionally, we considered cases within the first 6 months of treatment for HER2+ early breast cancer (EBC). RESULTS.: A total of 23 RCTs and 41 reports were included in our analysis. LABC and mBC showed no statistically significant difference in any of the comparisons of T-DM1 versus the other anti-HER2+ therapies. When assessing progression-free survival (PFS), trastuzumab-deruxtecan (T-DXd) and PyroCap demonstrated greater efficacy compared to other treatments (Hazard Ratio [HR]: 3.57; 95% confidence interval [CI]: 2.75-4.63 and HR: 1.82; 95% CI: 1.35-2.44; respectively), while T-DM1 alone exhibited superior effectiveness compared to LapCap (HR: 0.65; 95% CI: 0.55-0.77), TrasCap (HR: 0.65; 95% CI: 0.46-0.91), LapCapCitu (HR: 0.60; 95% CI: 0.33-1.10), Nera (HR: 0.55; 95% CI: 0.39-0.77), and Cap (HR: 0.37; 95% CI: 0.28-0.49). CONCLUSIONS.: NMA allows a ranking based on the comparative efficacy and safety among the interventions available. Although superior to other schemes, T-DM1 showed a lower efficacy performance in PFS and overall response rate and a trend towards worse overall survival than T-DXd.

Indexed as

Ado-Trastuzumab EmtansineAntineoplastic Agents, ImmunologicalBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesAntineoplastic Combined Chemotherapy ProtocolsFemaleHumansMaytansineNeoplasm MetastasisRandomized Controlled Trials as TopicTrastuzumabAdo-Trastuzumab EmtansineAntineoplastic Agents, ImmunologicalERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesMaytansineTrastuzumab

Identifiers

PMID38808848
PMCPMC11152244

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.