Efficacy and safety of trastuzumab deruxtecan in the treatment of breast cancer:a Meta-analysis
Objective To systematically evaluate the efficacy and safety of trastuzumab deruxtecan(T-Dxd)in the treatment of breast cancer.Methods PubMed,Cochrane Library,Embase,Web of Science,SinoMed,CNKI,WanFang Data,and VIP databases were electronically searched to collect randomized controlled trials(RCTs)of T-Dxd(test group)versus chemotherapeutic agents or other antineoplastic agents(control group)from inception to February 15,2024.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias in the included studies.Meta-analysis was performed by using RevMan 5.3.1 software.Results A total of 3 RCTs involving 1 689 patients were included.The results of the Meta-analysis indicated that the progression-free survival(PFS)(HR=0.37,95％CI 0.27 to 0.51,P＜0.001),overall survival(OS)(HR=0.63,95％CI 0.53 to 0.75,P＜0.001),and objective response rate(ORR)(RR=2.52,95％CI 2.21 to 2.88,P＜0.001)in the test group were significantly superior to or higher than those of the control group.The incidence of drug-related interstitial lung disease(RR=10.82,95％CI 4.83 to 24.23,P＜0.001)and reduced ejection fraction(RR=5.05,95％CI 1.91 to 13.33,P=0.001)was significantly higher in patients in the test group than in the control group.Subgroup analysis showed that hormone receptor-positive and hormone receptor-negativity,brain metastasis,and no brain metastasis patients who received T-Dxd had longer PFS(P＜0.001).The results of sensitivity analysis showed that the results obtained were more robust when PFS,OS,and ORR were used as indicators.Conclusion Current evidence suggests that T-Dxd can prolong PFS and OS and improve ORR in breast cancer than chemotherapeutic agents or other antineoplastic agents,however,it may increase the risk of interstitial lung disease and reduce ejection fraction.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.
Trastuzumab deruxtecanAntibody drug conjugatesBreast cancerEfficacySafetyMeta-analysisRandomized controlled trial
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维普
