临床与病理杂志2017，Vol.37Issue(8)：1678-1685,8.DOI:10.3978/j.issn.2095-6959.2017.08.023
曲妥珠单抗治疗乳腺癌患者心脏毒性的Meta分析
Cardiotoxicity of trastuzumab in breast cancer patients: a meta-analysis
摘要
Abstract
Objective: To investigate the incidence and classification of cardiac toxicity in patients with HER2 positive breast cancer who treated with trastuzumab. Methods: The relevant literature were searched in PubMed, EMBASE, Web of Science and Cochrane library until December, 2016. Phase Ⅲ RCTs were included according to inclusion criteria for screening and assessment of the literature ultimately. As the system evaluation method of Cochrane Handbook 5.1.0, the literature was screened, data were extracted and checked by 2 reviewers respectively. Meta-analysis was then performed using R software to compare the treatment of trastuzumab and traditional treatment on cardiotoxicity in patients with breast cancer. Results expressed as the relative risk (RR) and 95％ confidence interval (CI). Results: A total of 6 RCTs involving 18622 patients were finally included, of which 11766 cases in trastuzumab group, and 6856 cases in the control group. Compared with the control group, Meta-analysis showed the occurrence of cardiac toxicity events which above grade Ⅱ increased significantly in experience group (RR=3.56, 95％CI 1.52-8.33, P<0.001). While the incidence of grade Ⅲ-Ⅳ was higher(RR=2.89, 95％CI 1.77-4.71, P<0.001). However, differences in the aspect of cardiac death had no significance. Subgroup analysis shows that the cardiotoxicity of grade Ⅱ by trastuzumab in Europe was higher than that of the United states. But there was no difference between the group that contains paclitaxel and/or anthracyclines and the group of without paclitaxel and anthracycline. Conclusion: This pooled analysis suggests that trastuzumab for patients with HER2 overexpress breast cancer is associate with increased risk of adverse cardiac events upon grade Ⅱ, Ⅲ. Nevertheless, there is no significant difference in the occurrence of cardiac death.关键词
乳腺癌/HER2阳性/曲妥珠单抗/心脏毒性/Meta分析Key words
breast cancer/HER2 positive/trastuzumab/cardiotoxicity/Meta-analysis引用本文复制引用
李信娟,黄浪,周建国,申莎莎,马虎..曲妥珠单抗治疗乳腺癌患者心脏毒性的Meta分析[J].临床与病理杂志,2017,37(8):1678-1685,8.基金项目
国家自然科学基金 (81360351,81660512),遵义医学院博士启动基金 (F-577),贵州省肿瘤学研究生工作站 [ 黔教研合 GZZ 字 (2016)06].This work was supported by the National Natural Science Foundation (81360351, 81660512), the Start-Up Fund for Doctors of Zunyi Medical University (F-577), the Postgraduate Workstation of Oncology of Guizhou Province [Qian Jiao Ke He GZZ (2016) 06], China. （81360351,81660512）
