Evidence mapPaperPMID 30428932Full record

SynthesisSystematic reviews2018

Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis.

Florence R Wilson, Megan E Coombes, Christine Brezden-Masley, Mariya Yurchenko, Quinlan Wylie, Reuben Douma, Abhishek Varu, Brian Hutton, Becky Skidmore, Chris Cameron

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Systematic reviews, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.

  1. Dual neoadjuvant blockade plus chemotherapy versus monotherapy for the treatment of women with non-metastatic HER2-positive breast cancer: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Alpha-smooth Muscle Actin Expression in the Stroma Predicts Resistance to Trastuzumab in Patients with Early-stage HER2-positive Breast Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2021
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. DE-ESCALATING TREATMENT FOR HER2-POSITIVE EARLY BREAST CANCER.Transactions of the American Clinical and Climatological Association · 2020
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Florence R WilsonCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada.
Megan E CoombesHoffmann-La Roche Limited, Mississauga, ON, Canada.
Christine Brezden-MasleySt. Michael's Hospital, Toronto, ON, Canada.
Mariya YurchenkoHoffmann-La Roche Limited, Mississauga, ON, Canada.
Quinlan WylieCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada.
Reuben DoumaCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada.
Abhishek VaruCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada.
Brian HuttonOttawa Hospital Research Institute, Ottawa, ON, Canada.
Becky SkidmoreIndependent Information Specialist, Ottawa, ON, Canada.
Chris CameronCornerstone Research Group Inc., Suite 204, 3228 South Service Road, Burlington, ON, L7N 3H8, Canada. ccameron@cornerstone-research.com.ORCID 0000-0003-3613-760X
Roche (Canada) · CACornerstone University · USSt. Michael's Hospital · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOriginator trastuzumab (Herceptin®; H) is an antibody-targeted therapy to treat patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC). We investigated the overall survival (OS) advantage conferred by the addition of H to chemotherapy for HER2+ EBC patients and how the OS advantage changed over time.

methodsA systematic literature review (SLR) identified randomized controlled trials (RCTs) and non-randomized studies (NRSs) published from January 1, 1990 to January 19, 2017, comparing systemic therapies used in the neoadjuvant/adjuvant settings to treat HER2+ EBC patients. Bayesian cumulative network meta-analyses (cNMAs) of OS were conducted to assess the published literature over time. Heterogeneity was assessed through sensitivity and subgroup analyses.

resultsThe SLR identified 31 unique studies (28 RCTs, 3 NRSs) included in the OS analyses from 2008 to 2016. In the reference case cNMA (RCTs alone), initial evidence demonstrated an OS advantage for H/chemotherapy compared with chemotherapy alone in HER2+ EBC patients. As additional OS data were published, the precision around this survival benefit strengthened over time. Both H/anthracycline-containing chemotherapy and H/non-anthracycline-containing chemotherapy regimens provided similar OS advantages for HER2+ EBC patients.

conclusionThis analysis represents the most comprehensive SLR/cNMA to date of published OS data in HER2+ EBC studies. These findings demonstrate why H/chemotherapy is now the established standard of care in HER2+ EBC. In the case of H, the benefits of early patient access far outweighed the risk of waiting for more precise information. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017055763.

Indexed as

AnthracyclinesAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesFemaleHumansSurvival RateTrastuzumabAnthracyclinesERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesTrastuzumabEarly breast cancerHER2-positive breast cancerNetwork meta-analysisSurvivalSystematic reviewTrastuzumab

Identifiers

PMID30428932
PMCPMC6237027
OpenAlexW2901939101

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.