A comparative meta-analysis between Trastuzumab Deruxtecan (T-DXd) and Pertuzumab, trastuzumab, and docetaxel (PTD) in metastatic HER2-positive breast cancer
DOI:
https://doi.org/10.58445/rars.2832Keywords:
HER2-positive breast cancer, Trastuzumab Deruxtecan (T-DXd), Pertuzumab Trastuzumab-Docetaxel (PTD), metastatic breast cancer, targeted therapy, meta-analysis, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), adverse events; interstitial lung disease (ILD), first-line therapy, second-line treatment, clinical outcomes, drug safetyAbstract
This meta-analysis investigates and compares the efficiency and safety profiles of Trastuzumab Deruxtecan (T-DXd) and the triplet regimen of Pertuzumab, Trastuzumab, and Docetaxel (PTD) in HER2-positive breast cancer. HER2-positive breast cancer is a subtype of breast cancer characterized by the overexpression of the HER2 protein. It is considered a significant subtype of breast cancer. Data from randomized controlled trials (RCTs), retrospective cohort studies, and real-world
observational studies published between 2013 and 2023. Primary evaluating points included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events; moreover, the statistical heterogeneity was evaluated using the I² statistic.
The analysis demonstrated that the PTD has superior ORR with an average of 83% across the selected studies, compared to 59.4% for T-DXd. PTD is used as the first-line treatment, while T-DXd is used as a second-line or later-line treatment. The OS showed longer outcomes in the PTD group (median OS up to 57.1 months in CLEOPATRA trial data), while T-DXd exhibited
extensive PFS outcomes in the pretreated patients, ranging from 9.3 to 17.8 months. A chi-square statistical analysis showed a significant difference in treatment efficacy favoring PTD (p< 0.05), particularly in first-line studies. In terms of safety, PTD was associated with a higher incidence of neutropenia, alopecia, and diarrhea, while interstitial lung disease (ILD) was
associated with T-DXd.
This meta-analysis demonstrates the superior efficiency of PTD in the first-line treatment of HER2-positive breast cancer and highlights the significant role of T-DXd in later lines of treatment.
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