Anne Julienne GenuinoUsa ChaikledkaewDue Ong TheThanyanan ReungwetwattanaAmmarin ThakkinstianFaculty of Medicine, Ramathibodi Hospital, Mahidol UniversityMahidol University2020-01-272020-01-272019-08-03Expert Review of Clinical Pharmacology. Vol.12, No.8 (2019), 815-82417512441175124332-s2.0-85068651856https://repository.li.mahidol.ac.th/handle/20.500.14594/51472© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Objective: Breast cancer remains to be the globally leading female cancer. About 15% to 20% of breast cancers have human epidermal growth factor receptor 2 (HER2)-positive tumors–a more aggressive breast cancer subtype with shortened survival. In the light of new and updated trial data on trastuzumab therapy for HER2-positive early-stage breast cancer (EBC), we conducted a systematic review and meta-analysis to update the pooling of its relative treatment effects. Methods: Systematic search was performed through Pubmed and Scopus to identify studies comparing survival outcomes and risks of heart toxicity effects of adjuvant trastuzumab with chemotherapy versus chemotherapy alone for HER2-positive EBC patients. Results: Based on the eight included studies in the review, combining trastuzumab with chemotherapy continues to show lowered death and relapse risks by one-third. The decision to initiate trastuzumab, however, needs to be prudently deliberated as two to three times more cardiotoxicity risk was shown to be associated with its use. Conclusion: Administering adjuvant trastuzumab in a weekly cycle concurrently with anthracycline-taxane chemotherapy regimen appears to be a preferable option to optimize its favorable effect in improving DFS and to prevent significantly higher risk for cardiotoxic effects.Mahidol UniversityMedicineArticleSCOPUS10.1080/17512433.2019.1637252