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Trastuzumab deruxtecan in human epidermal growth factor receptor 2-positive breast cancer brain metastases: a systematic review and meta-analysis

dc.contributor.authorMichelon, I
dc.contributor.authorVilbert, M
dc.contributor.authorMarinho, AD
dc.contributor.authorCastro, CER
dc.contributor.authorDacoregio, MI
dc.contributor.authorStecca, C
dc.contributor.authorSoares, LR
dc.contributor.authorBatista, MV
dc.contributor.authorBraga, S
dc.contributor.authorSaeed, A
dc.contributor.authorCavalcante, L
dc.date.accessioned2024-02-18T21:43:37Z
dc.date.available2024-02-18T21:43:37Z
dc.date.issued2024
dc.description.abstractBackground: Trastuzumab deruxtecan (T-DXd) has shown promising results in patients with breast cancer brain metastases (BCBMs). We conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of T-DXd in the human epidermal growth factor receptor 2 (HER2)-positive BCBM population. Patients and methods: We searched PubMed, Embase, and Cochrane Library databases as well as American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), and San Antonio Breast Cancer Symposium (SABCS) websites for clinical trials (CTs) and observational studies evaluating T-DXd in patients with HER2-positive BCBM. Heterogeneity was assessed with I2 statistics. Random effects models were used for all statistical analyses, which were carried out using R software (version 4.2.2). Results: Ten studies were included, six CTs (n = 189) and four observational studies (n = 130), with a total of 319 patients. The median progression-free survival was 15 months [95% confidence interval (CI) 13.9-16.1 months]. The objective response rate (ORR) was 61% (95% CI 52% to 70%), and the intracranial (IC)-ORR was 61% (95% CI 54% to 69%). No significant differences in ORR and IC-ORR were observed between CTs and observational studies (P = 0.31 and 0.58, respectively). The clinical benefit rate (CBR) was 80% (95% CI 52% to 94%), and the IC-CBR was 70% (95% CI 54% to 82%). The ORR was 68% (95% CI 57% to 77%) in the subgroup of patients with stable BMs and 60% (95% CI 48%-72%) in patients with active BM, with no significant difference between groups (P = 0.35). Conclusions: Our systematic review and meta-analysis supports the IC activity of T-DXd in patients with stable BM and active BM. Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) under the protocol number CRD42023422589.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationESMO Open . 2024 Feb 5;9(2):102233.pt_PT
dc.identifier.doi10.1016/j.esmoop.2024.102233pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/49880
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectNeoplasias da Mamapt_PT
dc.subjectNeoplasias Cerebrais/secundáriaspt_PT
dc.subjectTrastuzumab/uso terapêuticopt_PT
dc.subjectBreast Neoplasmspt_PT
dc.subjectBrain Neoplasms/secondarypt_PT
dc.subjectTrastuzumab/therapeutic usept_PT
dc.titleTrastuzumab deruxtecan in human epidermal growth factor receptor 2-positive breast cancer brain metastases: a systematic review and meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue2pt_PT
oaire.citation.startPage102233pt_PT
oaire.citation.titleESMO Openpt_PT
oaire.citation.volume9pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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