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Comparative Efficacy and Safety of Anti-HER2 Therapies in Breast Cancer

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In a comprehensive network meta-analysis, the relative effectiveness of trastuzumab-emtansine (T-DM1) and other anti-HER2 therapies in treating HER2-positive breast cancer was examined. HER2-positive breast cancer, known for its aggressive nature, necessitates effective treatment strategies to improve patient outcomes. This study offers insights into the comparative performance of these treatments, providing crucial information for healthcare professionals in optimizing therapeutic approaches.

Study Objective and Methodology

The primary aim was to evaluate the efficacy and safety of T-DM1 against other anti-HER2 therapies. The analysis included 23 randomized controlled trials (RCTs) and 41 reports, focusing on patients with unresectable locally advanced breast cancer (LABC) or metastatic breast cancer (mBC). Treatment regimens involving trastuzumab and taxanes were considered, as well as cases within the first six months of treatment for HER2-positive early breast cancer (EBC).

Key Findings and Implications

The results revealed no significant differences in efficacy between T-DM1 and other anti-HER2 therapies in LABC and mBC. However, when examining progression-free survival (PFS), trastuzumab-deruxtecan (T-DXd) and PyroCap showed superior performance compared to other treatments. T-DM1 exhibited greater effectiveness than several other therapies, including LapCap, TrasCap, LapCapCitu, Nera, and Cap.

Despite T-DM1’s overall superiority, it demonstrated a lower efficacy in PFS and overall response rate compared to T-DXd. Additionally, a trend towards worse overall survival was observed with T-DM1.

Concrete Inferences for Clinical Practice

– Trastuzumab-deruxtecan (T-DXd) and PyroCap may be preferred for patients with a focus on progression-free survival.
– T-DM1 remains a viable option but may not be the best choice for achieving the longest progression-free survival.
– Healthcare providers should consider individual patient profiles and treatment goals when selecting an anti-HER2 therapy.
– Further research and continuous monitoring are essential to refine treatment strategies and enhance patient outcomes.

The study’s findings underscore the importance of personalized treatment plans in managing HER2-positive breast cancer. By comparing the efficacy and safety of various therapies, healthcare professionals can make informed decisions, potentially improving health outcomes and quality of life for patients.

Original Article: Rev Peru Med Exp Salud Publica. 2024 May 27;41(1):7-18. doi: 10.17843/rpmesp.2024.411.13351.

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