摘要
目的探索靶向药物联合化疗一线治疗人表皮生长因子受体2(HER2)阳性晚期乳腺癌的药物的安全性、有效性。方法检索PubMed、Cochrane Library、Web of Science核心合集数据库、中国知网中关于靶向药物联合化疗一线治疗HER2阳性晚期乳腺癌的随机对照试验,检索时限建库至2024年12月。对符合纳入标准的文献进行网状meta分析。结果本研究共纳入8项随机对照试验,共涉及2901例患者和5种治疗措施。无进展生存期方面:各方案之间比较,差异无统计学意义(P>0.05),根据累积排序概率曲线下面积(SUCRA)值排序显示,吡咯替尼+曲妥珠单抗+多西他赛成为延长无进展生存期最佳措施的可能性最大(SUCRA=0.86);客观缓解率方面,吡咯替尼+曲妥珠单抗+多西他赛干预组与对照组(OR=1.10,95%CI=1.00~1.30)比较,差异有统计学意义(P<0.05),其他各不同方案比较,差异无统计学意义(P>0.05),根据SUCRA值排序显示,吡咯替尼+曲妥珠单抗+多西他赛成为提高客观缓解率最佳措施的可能性最大(SUCRA=0.90);安全性方面:吡咯替尼+曲妥珠单抗+多西他赛干预组与对照组比较(OR=2.14,95%CI=1.04~4.42),差异有统计学意义(P<0.05),其他各不同方案间比较,差异无统计学意义(P>0.05)。SUCRA排序结果显示,曲妥珠单抗+多西他赛成为安全性最佳治疗措施的可能性最大(SUCRA=0.08)。结论目前研究表明,吡咯替尼联合方案在生存获益较其他方案疗效较好,未来的研究应更重视其安全性,个体化制订治疗方案。
Objective To investigate the safety and efficacy of targeted drugs combined with chemotherapy as the first-line treatment for human epidermal growth factor receptor 2(HER2)-positive advanced breast cancer.Methods Randomized controlled trials on the use of targeted drugs combined with chemotherapy as the first-line treatment for HER2-positive advanced breast cancer were retrieved from PubMed,Cochrane Library,Web of Science core collection database,and CNKI.The search period was from the database establishment to December 2024.A network meta-analysis was conducted on the literatures that met the inclusion criteria.Results A total of eight randomized controlled trials involving 2901 patients and five therapeutic regimens were included in this study.In terms of progress free survival,comparisons among the various schemes showed no statistically significant difference(P>0.05).According to the ranking based on the surface under the cumulative ranking(SUCRA)value,Pyrotinib+Trastuzumab+Docetaxel was shown to have the highest possibility of being the best measure for prolonging progress free survival(SUCRA=0.86).In terms of objective response rate,the intervention group of Pyrotinib+Trastuzumab+Docetaxel showed a statistically significant difference compared with the control group(OR=1.10,95%CI=1.00-1.30)(P<0.05).Comparison among other different schemes showed no statistically significant difference(P>0.05).According to the ranking based on the SUCRA value,Pyrotinib+Trastuzumab+Docetaxel was the measure with the highest possibility of improving the objective response rate(SUCRA=0.90).In terms of safety,the intervention group of Pyrotinib+Trastuzumab+Docetaxel showed a statistically significant difference compared with the control group(OR=2.14,95%CI=1.04-4.42)(P<0.05).Comparison among other different schemes showed no statistically significant difference(P>0.05).The SUCRA ranking results indicated that Trastuzumab+Docetaxel had the highest probability of being the safest treatment option(SUCRA=0.08).Conclusion Current research indicates that the Pyrotinib combination therapy offers better survival benefits compared to other treatment regimens.Future studies should place greater emphasis on its safety and develop individualized treatment plans.
作者
刘雨蒙
蒋婷婷
张妮
李艳平
刘耀
LIU Yumeng;JIANG Tingting;ZHANG Ni;LI Yanping;LIU Yao(Department of Pharmacy,Daping Hospital,Army Medical University,Chongqing 400042,China)
出处
《中国医药导报》
2026年第5期74-79,共6页
China Medical Herald
基金
创新药物上市后临床研究科研专项(WKZX2023CX210006)。
关键词
靶向药物
化疗
乳腺癌
网状meta分析
Targeted drugs
Chemotherapy
Breast cancer
Network meta-analysis
