SynthesisFrontiers in pharmacology2025
Subcutaneous versus intravenous trastuzumab for HER2-positive breast cancer: a global systematic review and meta-analysis with a cost-minimization analysis from the Chinese healthcare system perspective.
Synthesis in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Subcutaneous (SC) trastuzumab offers a more convenient alternative to intravenous (IV) administration for HER2-positive breast cancer, potentially improving healthcare efficiency and patient experience. Although SC trastuzumab was approved in Europe in 2013 and in the United States in 2019, it only became available in China in 2022, highlighting the need to synthesize global evidence for regions where SC adoption is recent. Methods: A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library through 20 March 2025, identified studies comparing SC and IV trastuzumab. Meta-analyses were performed using random- or fixed-effects models to evaluate pathological complete response (pCR), event-free survival (EFS), adverse events, serious adverse events, and patient preference. A cost-minimization analysis (CMA) was additionally performed from the perspective of the Chinese healthcare system. Results: Nine studies were included. SC trastuzumab demonstrated comparable pCR (OR = 1.11, 95% CI: 0.86-1.42) and EFS (HR = 0.96, 95% CI: 0.78-1.19) to IV administration. SC was associated with a higher incidence of mild-to-moderate local reactions (OR = 1.59, 95% CI: 1.38-1.84) but no significant difference in serious adverse events (OR = 1.37, 95% CI: 0.94-1.99). Patient preference strongly favored SC (OR = 63.02, 95% CI: 34.43-115.34). Cost-minimization analysis showed that 18 cycles of SC trastuzumab (100,597 CNY) reduced costs by approximately 7% compared with the IV originator (108,032 CNY) and were generally comparable to domestic biosimilars, which ranged from 79,432 to 101,817 CNY. Conclusion: SC trastuzumab demonstrates comparable clinical outcomes to IV administration, with a marked patient preference advantage and potential cost savings compared with the IV originator and domestic biosimilars. These findings are particularly relevant to healthcare systems where SC formulations are newly introduced, providing timely evidence to guide patient-centered clinical decision-making. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=637674, identifier CRD42025637674.
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