Pertuzumab 1.2g/15ml / Trastuzumab 600mg/15ml solution for injection vials

BackgroundHER2 amplification identifies a subgroup of colorectal cancer with poorer prognosis and resistance to anti-EGFR therapy. We conducted a systematic review and a meta-analysis of available data on anti-HER2 treatments (HER2Tx) in mCRC patients (pts).MethodsA systematic literature search was performed, encompassing phase II/III clinical trials (CTs) investigating HER2Tx in HER2-overexpressed mCRC. CTs reporting HER2Tx plus chemotherapy were excluded. Primary endpoints were objective response rate (ORR) and disease control rate (DCR). Fixed and random-effect models were applied according to heterogeneity assessed through I 2 statistics. Progression-free survival (PFS) and overall survival (OS) were compared descriptively and pooled using the weighted median of medians (WM) with approximated 95% CIs. Subgroup analyses by HER2Tx were carried out.ResultsThe analysis included 10 CTs evaluating Trastuzumab-Pertuzumab (T + P, 5 CTs,), Trastuzumab Deruxtecan (T-DXd, 2 CTs), Trastuzumab-Lapatinib (T + L, 1 CT), Pertuzumab-TDM1 (P+TDM1, 1 CT), and Trastuzumab-Tucatinib (T-Tu, 1 CT), for a total of 467 pts. The pooled ORR was 33.7% (29.6%-38.1%), and the pooled DCR was 68.5% (58.1%-77.4%). The WM OS was 13.4 months (10-24.1) and WM PFS was 5.5 months (4.1-6.9). The T-DX and T-Tu groups showed higher ORR and DCR (38% and 39% respectively, 85.1% and 73.2% respectively) compared to the T + P group (ORR, 30%; DCR, 52.6%).ConclusionsHER2Tx demonstrated efficacy in pretreated CRC pts, exhibiting good DCR and ORR alongside promising PFS and OS. T-DXd and T-Tu appear to outperform T + P; however, further studies are needed.

Abstract licence: CC BY-NC

BackgroundNeoadjuvant drug therapy has become an important component of multidisciplinary cancer treatment, but newer targeted, immunotherapy-based, and multi-agent regimens are often associated with higher costs and uncertainty regarding long-term economic value. This systematic review evaluates the economic evidence for neoadjuvant drug regimens in cancer and summarizes key cost-effectiveness findings across tumor types and healthcare settings.MethodsWe systematically searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to June 1, 2026. Eligible studies were full economic evaluations comparing neoadjuvant drug regimens or assessing the addition of a specific drug component to a baseline neoadjuvant regimen in patients with cancer. Studies comparing neoadjuvant drug regimens with non-drug-based or non-neoadjuvant strategies were excluded. Study selection and data extraction were performed independently by two reviewers. Reporting completeness was assessed using the CHEERS 2022 checklist, potential sources of bias were assessed using the ECOBIAS checklist, and findings were narratively synthesized.ResultsA total of 2,572 records were identified, and 7 studies met the inclusion criteria. The included studies were published between 2015 and 2024 and involved breast cancer, muscle-invasive bladder cancer, and borderline resectable or locally advanced pancreatic cancer. Five studies focused on breast cancer, mainly HER2-positive disease. Most studies used model-based approaches and quality-adjusted life-years as the primary outcome. Pertuzumab-based neoadjuvant regimens for HER2-positive breast cancer and FOLFIRINOX for pancreatic cancer were generally reported to be cost-effective in their respective healthcare settings. In contrast, neoadjuvant pembrolizumab for muscle-invasive bladder cancer and AC-TH compared with TCH for breast cancer were not cost-effective under base-case assumptions. Key drivers included pathological complete response, recurrence or progression risk, drug costs, utility values, adverse event costs, time horizon, and assumptions linking short-term efficacy to long-term outcomes.ConclusionCurrent economic evidence remains limited and concentrated mainly in HER2-positive breast cancer. Cost-effectiveness conclusions depend strongly on drug prices, downstream treatment costs, and model-based extrapolation of early efficacy endpoints. Future studies should incorporate long-term follow-up and real-world evidence.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261462564, Identifier CRD420261462564.

Abstract licence: CC BY