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1、Mendesetal.BreastCancerResearch(2015)17:140DOI10.1186/s13058-015-0648-2RESEARCHARTICLEOpenAccessThebenefitofHER2-targetedtherapiesonoverallsurvivalofpatientswithmetastaticHER2-positivebreastcancer–asystematicreview1,2*1,23456DiogoMendes,CarlosAlves,NoémiaAfonso,Fáti
2、maCardoso,JoséLuísPassos-Coelho,LuísCosta,71,2SofiaAndradeandFranciscoBatel-MarquesAbstractIntroduction:Thisstudyaimedatevaluatingtheoverallsurvival(OS)gainassociatedwithhumanepidermalgrowthfactorreceptor2(HER2)-directedtherapiesinpatientswithmetastaticbreastcancer(
3、mBC).Methods:AbibliographicsearchwasconductedinPubMedandCochranedatabases.OnlyphaseIIIrandomizedcontrolledtrials(RCTs)includingHER2-positive(HER2+)mBCpatientswereincludedinthisreview.OSwasdefinedastimefromrandomizationuntiltheoccurrenceofdeathfromanycause.Studieshav
4、ebeengroupedaccordingtothelineoftreatment,i.e.,first-lineorsecond-lineorbeyond.Results:NineteenRCTswereeligibleforinclusion,ofwhich12assessedtherapiestargetingHER2+mBCinthefirst-linesetting.OSimprovedfrom20.3monthsinthefirstRCT(standardchemotherapy;Slamonetal.(NEngl
5、JMed344:783–92,2001))evaluatingHER2-targetingtherapiesto48monthsinthestudyofSwainetal.(LancetOncol14:461–71,2013),withtriplecombinationofpertuzumab,trastuzumabanddocetaxel.SevenRCTsevaluatedtheOSofHER2-targetingtherapiesinthesecond-linesettingandbeyond.TheOSinsecond
6、-linesettingimprovedfrom15.3months(capecitabine;Cameronetal.(BreastCancerResTreat112:533–43,2008))to30.7months(trastuzumabemtansine;Vermaetal.(NEnglJMed367:1783–91,2012)).Inthethird-linesetting,theassociationoflapatinibandtrastuzumabhasdemonstratedtoimproveOSto4.5mo
7、nthscomparedwithlapatinibalone(14monthsvs.9.5months;Blackwelletal.(JClinOncol30:2585–92,2012)).Conclusions:HER2-directedtherapieshadanundeniablebeneficialimpactontheOSofpatientswithHER2+mBC.Thetriplecombinationofdocetaxel,pertuzumabandtrastuzumabisassociatedwithasur
8、vivalextentofmorethan4.5years,comparedwithalifeexpectancyof1.5yearsachieved14yearsago.Introductionanditisthemostfrequentcauseofcancerdeath