Efficacy and safety of different drugs in patients with HER2-positive gastric cancer: network meta-analysis.

IF 6.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews Pub Date : 2025-02-10 DOI:10.1186/s13643-025-02777-4

Jie Zhang, Chunluan Yuan, Xiao Ma

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引用次数: 0

Abstract

Background: In the past decade, there has been a significant advancement in targeted therapy and immunotherapy, leading to the discovery of new drugs and changes in the treatment approach for patients with HER2-positive gastric cancer. Although several drugs are available for treating these patients, there is still no consensus on their selection, and there has been limited direct or indirect comparison among them.

Objective: To address this gap, a network meta-analysis was conducted to assess the efficacy and safety of different drugs used in the treatment of HER2-positive gastric cancer.

Methods: By searching through databases such as PubMed, Embase, Web of Science, and Cochrane Library, we identified 16 randomized controlled trials that involved a total of 4485 patients and utilized 9 different intervention measures.

Results: Based on the current evidence, compared with chemotherapy alone, the hazard ratio (HR) of overall survival (OS) and progression-free survival (PFS) in gastric cancer patients treated with nivolumab were [hazard ratio (HR): 2.61 95%confidence interval (CI) (1.51, 4.51)] and [hazard ratio (HR): 2.01 95% confidence interval (CI) (1.18, 3.42)], respectively. Compared with chemotherapy alone, the hazard ratio (HR) of overall survival (OS) and progression-free survival (PFS) in gastric cancer patients treated with trastuzumab deruxtecan were [hazard ratio (HR): 1.7 95% confidence interval (CI) (1.13, 2.56)] and [hazard ratio (HR): 2.13 95% confidence interval (CI) (1.42, 3.22)], respectively. It is suggested that nivolumab and trastuzumab deruxtecan can effectively prolong overall survival (OS) and progression-free survival(PFS) in patients with HER2-positive gastric cancer, while also reducing the risk of adverse events to some extent. Therefore, these two regimens, nivolumab and trastuzumab deruxtecan, are considered to be effective and safe options for the treatment of patients with HER2-positive gastric cancer.

Conclusions: In previous studies, trastuzumab-based chemotherapy has been a common treatment for HER2-positive gastric cancer. To a certain extent, our study provides a reliable direction for future treatment options for HER2-positive gastric cancer.

Systematic review registration: PROSPERO CRD42023420941.

查看原文本刊更多论文

不同药物对HER2阳性胃癌患者的疗效和安全性：网络荟萃分析。

背景：近十年来，靶向治疗和免疫治疗取得了重大进展，导致her2阳性胃癌患者的新药物的发现和治疗方法的改变。虽然有几种药物可用于治疗这些患者，但对它们的选择仍然没有共识，并且它们之间的直接或间接比较有限。目的：为了弥补这一空白，我们进行了一项网络荟萃分析，以评估不同药物治疗her2阳性胃癌的疗效和安全性。方法：通过检索PubMed、Embase、Web of Science和Cochrane Library等数据库，我们确定了16项随机对照试验，共涉及4485例患者，采用了9种不同的干预措施。结果：基于目前的证据，与单独化疗相比，纳武单抗治疗胃癌患者的总生存期（OS）和无进展生存期（PFS）的风险比（HR）分别为[风险比（HR）： 2.61 95%可信区间（CI）（1.51, 4.51）]和[风险比（HR）： 2.01 95%可信区间（CI）（1.18, 3.42）]。与单纯化疗相比，曲妥珠单抗治疗胃癌患者的总生存期（OS）和无进展生存期（PFS）的风险比（HR）分别为[风险比（HR）： 1.7 95%可信区间（CI）（1.13, 2.56）]和[风险比（HR）： 2.13 95%可信区间（CI）（1.42, 3.22）]。提示纳武单抗和曲妥珠单抗德鲁西替康可有效延长her2阳性胃癌患者的总生存期（OS）和无进展生存期（PFS），同时在一定程度上降低不良事件发生的风险。因此，纳武单抗和曲妥珠单抗德鲁西替康这两种方案被认为是治疗her2阳性胃癌患者的有效和安全的选择。结论：在以往的研究中，曲妥珠单抗为基础的化疗是her2阳性胃癌的常用治疗方法。在一定程度上，我们的研究为未来her2阳性胃癌的治疗选择提供了可靠的方向。系统评价注册：PROSPERO CRD42023420941。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Systematic Reviews Medicine-Medicine (miscellaneous)

CiteScore

8.30

自引率

0.00%

发文量

241

审稿时长

11 weeks

期刊介绍： Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.