SynthesisFrontiers in pharmacology2026
Efficacy and safety of antibody-drug conjugates in pretreated HER2-positive advanced breast cancer: a network meta-analysis of randomized controlled trials.
Synthesis in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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5 authors.
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Abstract
Background: Antibody-drug conjugates (ADCs) have become the standard treatment for HER2-positive(HER2+)advanced breast cancer following the failure of trastuzumab or taxane. Nevertheless, there are no direct head-to-head trials comparing different ADCs. Methods: We searched PubMed, Embase, the Cochrane Library and abstracts from major oncology conferences, and included phase III randomized controlled trials (RCTs) investigating HER2-targeting ADCs. We conducted a frequentist random-effects NMA, and utilized the P-score to rank the efficacy of included treatments. The outcome indicators include progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs). Results: Seven RCTs involving 3,160 patients and seven ADCs (T-DM1, ARX788, A166, SHR-A1811, RC48, DP303c and T-DXd) were included in our research. All ADCs showed a significant PFS benefit versus chemotherapy plus tyrosine kinase inhibitor (Chem + TKI). T-DXd showed the most favorable PFS (HR = 0.18, 95%CI: 0.13-0.25), followed by SHR-A1811 (HR = 0.22, 95%CI: 0.15-0.33) compared with Chem + TKI. SHR-A1811 showed a promising OS signal(HR = 0.31, 95% CI: 0.14-0.69), followed by T-DXd (HR = 0.41, 95% CI: 0.26-0.66) compared with Chem + TKI. For safety, T-DXd exhibited the highest odds for all-grade TRAEs relative to all included control treatments, with statistically significant differences identified when compared with T-DM1 and Chem + TKI., T-DM1 demonstrated better safety characteristics for grade ≥3 TRAEs, with a significantly lower odds of occurrence than SHR-A1811, ARX788, DP303c, and Chem + TKI. Conclusion: Included anti-HER2 ADCs significantly improve PFS over Chem + TKI, among which T-DXd and SHR-A1811 deliver notable survival benefits. Although T-DXd is associated with a higher odd of all-grade TRAEs and T-DM1 exhibits favourable grade ≥3 safety. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251234345, identifier CRD420251234345.
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