Summary

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• This summary is based on the review of 27 systematic review(s)/meta-analysis(es). ^[1-27]
• In first-line and second-line treatments for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, median overall survival (OS) was 11 months for pertuzumab (Pmab) + trastuzumab (Tmab) + eribulin (ERI), 10 months for Tmab + ERI, and 8.9 months for ERI alone.
• In neoadjuvant therapy, the addition of pertuzumab significantly increased pathologic complete response (pCR) rates with an odds ratio (OR) of 2.10 (95% confidence interval (CI): 1.56-2.83) compared to trastuzumab alone.
• For dual HER2 blockade, trastuzumab combined with tyrosine kinase inhibitors (TKIs) showed improved progression-free survival (PFS) and objective response rate (ORR) over single-agent or monotherapy options.
• Bayesian network meta-analysis indicated that the combination of trastuzumab, pertuzumab, and chemotherapy was superior in terms of PFS and ORR compared to monochemotherapy or adding anthracyclines.
• Grade ≥ 3 adverse events were more frequent with dual HER2 therapy, with significant risks of diarrhea (relative risk (RR) = 2.36, 95% CI: 1.98-2.81), anemia (RR = 1.43, 95% CI: 1.17-1.75), and rash (RR = 1.62, 95% CI: 1.38-1.90).
• Cardiotoxicity risk was elevated with dual HER2 therapy, showing an increased likelihood of clinical heart failure (RR = 1.97, 95% CI: 1.05-3.70), though minimal increase in asymptomatic left ventricular dysfunction (RR = 1.19, 95% CI: 0.89-1.61).
• Pertuzumab-based regimens, compared to non-pertuzumab regimens, presented higher occurrences of febrile neutropenia, diarrhea, and anemia, particularly among Asian patients, who showed a higher profile of Grade ≥ 3 and serious adverse events.
• There is no population type or subgroup information available in the reviewed studies.