乳腺癌心脏毒性荟萃分析

　　2016年6月17日，意大利医学会官方期刊《泛密涅瓦医学》在线发表伊朗德黑兰巴奇亚塔拉医科大学的乳腺癌心脏毒性荟萃分析，发现射血分数（比值比0.98，95%置信区间：0.63～1.54，P=0.96）和左室射血分数（比值比：1.04，95%置信区间：0.69～1.56，P=0.85）无显著降低。其中，曲妥珠单抗＋拉帕替尼的合并比值比为0.99（95%置信区间：0.79～1.28），曲妥珠单抗＋帕妥珠单抗的合并比值比为1.00（95%置信区间：0.88～1.13）。

Panminerva Med. 2016 Jun 17. [Epub ahead of print]

Applications of cardio-toxicity in breast cancer: a meta-analysis.

Rahmani H, Shahriary A, Sheikhi MA, Ebadi A, Davoodzadeh H.

Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

INTRODUCTION: Breast cancer is the most common type of cancer in women. Many antineoplastic agents used to treat breast cancer have potentially cardiotoxic effects and may lead to chemotherapy induced cardiomyopathy and heart failure. We conducted a meta analysis to clarify the applications of cardiotoxicity in breast cancer.

MATERIAL METHODS: A published literature search was performed through Pubmed, Cochrane Library, Medline, and Science Citation Index Expanded databases for articles published in English. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using random or fixed effects models. Heterogeneity was assessed using chi-square and I 2 statistics. We performed a formal meta-analysis using summary measures from these studies.

RESULTS: In total, 9 published studies were included in the final analysis. The combined analysis revealed that there was nonsignificant regardless of the statistical Ejection fraction (OR=0.98, 95% CI: 0.63 to 1.54, P=0.96) and Left ventricular ejection fraction (1.04, 95% CI: 0.69-1.56, P=0.85) decline method used. Additionally, the pooled OR was 0.99 (95% CI: 0.79-1.28) for the trastuzumab plus lapatinib combination, and 1.00 (95% CI: 0.88-1.13) for the trastuzumab plus pertuzumab combination.

CONCLUSIONS: In this Meta-Analysis, there was evidence indicated that there was not a significant decrease on LVEF and EF in patients who received trastuzumab plus lapatinib and trastuzumab plus pertuzumab combination. Our study suggests that the combination of two anti HER2 agents does not significantly increase the risk for adverse compared with anti-HER2 monotherapy in patients with adequate cardiac function prior to start of therapy.

PMID: 27314979