Efficacy and safety of anti-HER2 therapy in solid tumors except breast cancer: a systematic-review and meta-analysis

Background: A meta-analysis was conducted to systematically evaluate the efficacy and safety of anti-Human epidermal growth factor receptor 2 (anti-HER2) therapy in solid tumors except breast cancer. Methods: The Cochrane Library, PubMed, EMbase, Clinical Trials and Web of Science databases were searched for studies published up to August 2022, which reported clinical randomized controlled trials (RCTs) of groups with anti-HER2 therapy (the experimental groups) and without anti-HER2 therapy (the control groups) for solid tumors except breast cancer. A structured meta analysis was conducted on fifteen studies using R 4.2.1, based on the extraction of the data and the risk of bias assessment under the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Results: Ten studies reported progression-free survival (PFS) with significantly lower risk of tumor progression in experimental groups than in control groups (hazard ratio (HR) = 0.82, 95% confidence interval (CI) (0.75, 0.90), p < 0.01). Seven studies reported overall survival (OS) with significantly longer overall survival in experimental groups than in control groups (HR = 0.89, 95% CI (0.79, 0.99), p = 0.03). The incidences of serious adverse events (SAEs) and any adverse events (AEs) in experimental groups were significantly higher than those in control groups (risk ratio (RR) = 1.35, 95% CI (1.04, 1.75), p = 0.03), (RR = 1.03, 95% CI (1.01, 1.06), p < 0.01). There was no significant difference between the incidences of anemia and fatigue in grade ≥3 AEs between the two groups (p > 0.05). The incidences of diarrhea, neutropenia, nausea, and vomiting were significantly higher in experimental groups than those in control groups (p < 0.05). Conclusions: The results reveal that anti-HER2 therapy is effective in the treatment of solid tumors except breast cancer, however some side effects should be carefully managed in clinical practice. The PROSPERO Registration: CRD42024625436.

Anti-HER2 therapy; Solid tumors; Breast cancer; Efficacy; Safety; Systematic-review; Meta-analysis

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