Among the remaining 10 articles, the NBRST, NeoSphere and PEONY studies reported the results of pertuzumab plus trastuzumab dual HER2-blockade therapy versus single-targeted therapy. showed a significant statistical LY3039478 difference between dual HER2-blockade treatment and single-agent treatment in a neoadjuvant setting for HER2+ breast cancer. Additionally, there was no statistically significant difference in disease-free survival (HR = 0.72; 95% CI: 0.47-1.09; p = 0.123), incidence of serious adverse events (SAEs) (RR = 1.04; 95%CI: 0.81-1.33; p = 0.778) and cardiotoxicity(RR = 1.30; 95%CI: 0.81-2.08; p = 0.280), and the pCR rate LY3039478 was unaffected by hormone receptor status. Conclusions: The pCR rate of neoadjuvant dual-target therapy for HER2+ breast cancer was significantly higher than that of single-target therapy. Furthermore, the results indicated that the safety of dual-target therapy is similar to that of single-target therapy. overexpression results in a highly invasive tumor and worse prognosis without appropriate treatment. For primary resectable HER2+ breast cancer, neoadjuvant anti-HER2 therapy has become a routine treatment,3 with trastuzumab representing the first targeted anti-HER2 drug.4 Other targeted anti-HER2 drugs include lapatinib, pertuzumab, neratinib, and so on. Lapatinib is a small-molecule tyrosine kinase inhibitor of the HER1 and HER2 receptors and that mainly inhibits signaling associated with downstream mitogen-activated protein kinase/extracellular signal-regulated kinase-1/2 and phosphoinositide 3-kinase/Akt pathways. Pertuzumab is a humanized monoclonal antibody that inhibits the formation of HER2CHER dimers. Trastuzumab is the cornerstone of HER2+ breast cancer anti-HER2 treatment, and despite significant effectiveness, there remain serious clinical problems, such as Rabbit Polyclonal to JunD (phospho-Ser255) recurrence and metastasis and acquired resistance in HER2+ patients.5-11 In order to overcome resistance to trastuzumab, combined treatment with other anti-HER2-targeting drugs has become a new therapeutic strategy; however, the ability of neoadjuvant dual-blockade anti-HER2 therapy to produce significant clinical improvement remains controversial.3 Here, we conducted a meta-analysis of neoadjuvant dual-blockade anti-HER2 drugs to comprehensively evaluate their clinical efficacy and safety in HER2+ breast cancer patients. Materials and Methods Search Strategy We searched PubMed, the Cochrane Library, Embase and ClinicalTrials. gov up to July 5, 2020, using subject headings and random words. The search strategy included the following terms: breast cancer, receptor ErbB-2, trastuzumab, lapatinib, pertuzumab, neratinib and neoadjuvant chemotherapy. The search terms were linked with AND or OR respectively and followed the Cochrane Handbook by using a combination of subject terms and free words, with searches of the literature included. Study Inclusion/Exclusion Criteria Studies needed to meet the following inclusion criteria to be eligible for the meta-analysis: 1) randomized clinical trials; 2) studies of HER2+ breast cancer and neoadjuvant dual-blockade anti-HER2 therapy; 3) involvement of at least 2 treatment options; 4) inclusion of data related to pathologic complete response, progression-free survival, disease-free survival (DFS), overall survival, and safety. Exclusion criteria for literature included the following: 1) similar studies were repeatedly published; 2) studies did not include neoadjuvant therapy; 3) corresponding data could not be obtained directly or indirectly; 4) review articles, case reports, comments, or letters. Quality Assessment The quality of the literature was evaluated using the Cochrane bias risk-assessment tool, including use of the random-allocation method, allocation scheme hiding, the blind method, and assessment of the integrity of results data, selective report research results, and other sources of bias. Two investigators (Chaokun Wang, Jing Chen) independently assessed quality, and in the event of disagreement, decisions were made based on discussions or evaluation by a third investigator. Data Extraction Data extraction was performed independently by 2 individuals (Chaokun Wang, Jing Chen) and according to a pre-designed data-extraction sample table, with the results crosschecked. Disagreements had been solved through negotiation. Extracted data included research calendar year and name, anti-HER2 LY3039478 treatment program, number of individuals, hormone receptor position, total pCR price, DFS, LY3039478 serious undesirable occasions (SAEs), and cardiac undesirable events. Statistical Evaluation Meta-analysis was performed using STATA 14.0 software program (Stata Corp, College Place, TX, USA). Heterogeneity between analytical research was performed using the Cochrane Q ensure that you the I2 statistic. In situations of no heterogeneity between outcomes (p 0.05; I2 50%), a.