American Association for Cancer Research
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Supplementary tables S1-S7 from Dual Block with Lapatinib and Trastuzumab Versus Single-Agent Trastuzumab Combined with Chemotherapy as Neoadjuvant Treatment of HER2-Positive Breast Cancer: A Meta-analysis of Randomized Trials

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journal contribution
posted on 2023-03-31, 18:17 authored by Matteo Clavarezza, Matteo Puntoni, Alessandra Gennari, Laura Paleari, Nicoletta Provinciali, Mauro D'Amico, Andrea DeCensi

Supplementary Table S1. Results of the summary evaluation on the risk of bias assessment, using the domain-based evaluation of the Cochrane risk of bias tool: low, unclear, and high risk of bias are the 3 possible judgments for each item considered of each of the study assessed. Supplementary Table S2. Detailed results of the risk of bias assessment on the NEOALTTO study (ref. 39). Supplementary Table S3. Detailed results of the risk of bias assessment on the CALGB 40601 study (ref. 40). Supplementary Table S4. Detailed results of the risk of bias assessment on the NSABP B-41 study (ref. 41). Supplementary Table S5. Detailed results of the risk of bias assessment on the EORTC 10054 study (ref. 42). Supplementary Table S6. Detailed results of the risk of bias assessment on the TRIO-US B07 study (ref. 43). Supplementary Table S7. Detailed results of the risk of bias assessment on the CHERLOB study (ref. 44).


Associazione Italiana per la Ricerca sul Cancro



Purpose: (Neo)adjuvant treatment with chemotherapy plus trastuzumab reduces recurrence and death risk in HER2-positive (HER2+) breast cancer. Randomized trials assessed HER2 dual block by adding lapatinib to trastuzumab and chemotherapy in the neoadjuvant setting using pathologic complete response (pCR) as the outcome measure. We conducted a meta-analysis of randomized trials testing neoadjuvant dual block with lapatinib and trastuzumab versus trastuzumab alone in HER2+ breast cancer.Experimental Design: Trials were identified by Medline (PubMed), ISI Web of Science (Science Citation Index Expanded), Embase, Cochrane library, and reference lists of published studies, review articles, editorials, and by hand-searched reports from major cancer meeting reports.Results: Six randomized trials including 1,155 patients were identified, of whom 483 (41.8%) were hormone receptor–negative, 672 (58.2%) hormone receptor–positive, 534 (46.2%) received taxanes alone, and 621 (53.8%) anthracyclines plus taxanes or the docetaxel–carboplatin regimen. Overall, the dual block was associated with a significant 13% absolute improvement in pCR rate compared with single-agent trastuzumab (summary risk difference, SRD 0.13; 95% CI, 0.08–0.19). The activity was greater in hormone receptor–negative patients who received chemotherapy with taxanes alone (SRD 0.25; 95% CI, 0.13–0.37), compared to hormone receptor–positive or hormone receptor–negative disease treated with anthracyclines plus taxanes or the docetaxel–carboplatin regimen (SRD 0.09; 95% CI, 0.02–0.15; Pinteraction = 0.05).Conclusions: On the basis of ΔpCR data, the dual block with trastuzumab and lapatinib plus chemotherapy is a very active treatment only in HER2+ and hormone receptor–negative breast cancer treated with taxane monochemotherapy. Clin Cancer Res; 22(18); 4594–603. ©2016 AACR.

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