The Efficacy and Safety of HER2-targeted Antibody-Drug Conjugates in
Gastric and Gastro-oesophageal Junction Cancer: A Systematic Review and
Meta-Analysis
Abstract
Background: The HER2-targeted antibody‒drug conjugate (ADC) is a novel
approach for anti-HER2 treatment, and its efficacy in breast cancer
patients has been demonstrated in clinical studies. However, the overall
efficacy and safety of the various HER2-targeted ADCs in patients with
gastric and gastroesophageal junction cancer has not been reported.
Method: The PubMed, Embase, Web of Science, Cochrane Central Register of
Controlled Trials (CENTRAL) and ClinicalTrials.gov databases were
systematically searched. We assessed the quality of the included studies
and then/span>extracted the overall response rate (ORR),
disease control rate (DCR), progression-free survival (PFS) and overall
survival (OS) to conduct the meta-analysis. Furthermore, we performed
subgroup and sensitivity analyses to explore the sources of
heterogeneity. The MINORS and RoB2 were used to assess the quality of
the included studies, and STATA 17.0 software was used for data
analysis. Results: Six single-arm studies and 2 randomized controlled
trials (RCTs) with a total of 871 patients were included. The pooled ORR
and DCR were 29% (95% CI: 20%-38%) and 71% (95% CI: 56%-86%),
respectively. The pooled mOS and mPFS were 9.68 months (95% CI:
7.78-11.58 months) and 5.60 months (95% CI: 4.59-6.61 months),
respectively. The incidence rates of all-grade adverse events (AEs) and
grade≥3 AEs were 98.8% and 58.8%, respectively (95% CI:
43.0%-74.5%). Conclusion: HER2-targeted ADCs showed great survival
benefits in GC/GEJC patients as second- and later-line treatments.
However, the relatively high incidence of grade≥3 AEs needs to be
considered.