文献类型：期刊文献

英文题名：Efficacy and Safety of Different Treatment Regimens for Previously Untreated Patients with HER2-positive Advanced Gastric Cancer: A Meta-Analysis of Randomized Controlled Trials

作者：He, Yuqi[1];Kang, Qi[1];Xu, Shanshan[1];Zhang, Zhongliang[1];Li, Sheng[1]

第一作者：He, Yuqi

通信作者：Li, S[1]

机构：[1]Gansu Univ Tradit Chinese Med, Peoples Hosp Lanzhou City 1, Clin Med Coll 2, Lanzhou, Gansu, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Tradit Chinese Med, Peoples Hosp Lanzhou City 1, Clin Med Coll 2, Lanzhou, Gansu, Peoples R China.|[10735]甘肃中医药大学;

年份：2025

卷号：56

期号：1

外文期刊名：JOURNAL OF GASTROINTESTINAL CANCER

收录：Scopus(收录号：2-s2.0-105024805245);WOS:【ESCI(收录号:WOS:001637519800001)】；

基金：This work is supported by the provincial natural science foundation project (No.24JRRA767).

语种：英文

外文关键词：Advanced gastric cancer; HER2 positive; Efficacy and safety

摘要：Objective The development of treatments for advanced gastric cancer (AGC) has made significant advances over the past decade. Although clinical trials for novel drugs targeting HER2-positive AGC are ongoing, current clinical management still faces challenges. Therefore, further comparison of the effectiveness of such combination therapies is needed.Methods comprehensive search was conducted in the PubMed, Embase, and Cochrane databases, with the search cut-off date set to May 2025. Outcomes were evaluated using indicators such as progression-free survival (PFS) and overall survival (OS).ResultsOur study included only randomized controlled trials comparing combination regimens of targeted and/or immunotherapy, involving 3,231 patients across eight different interventions.The network meta-analysis revealed that no treatment regimen demonstrated a statistically significant improvement in OS or PFS. However, a trend toward improved PFS was observed with HLX22 plus HLX02 and chemotherapy compared to trastuzumab-based chemotherapy, although the difference was not statistically significant (MD=-0.94, 95% CI: -5.26-3.37). Pembrolizumab in combination with trastuzumab and chemotherapy significantly improved the objective response rate (ORR).Cumulative ranking probabilities indicated that trastuzumab plus chemotherapy may be associated with the longest PFS, while chemotherapy alone ranked highest in OS, though all confidence intervals included the null value.Conclusion No first-line regimen significantly improved OS or PFS in HER2-positive advanced gastric cancer. However, HLX22-based and immune-combination strategies show potential clinical value-particularly in enhancing ORR-and merit further investigation.