Predictive and prognostic value of PIK3CA mutations in HER2-positive breast cancer treated with tyrosine kinase inhibitors: A systematic review and meta-analysis

Biochim Biophys Acta Rev Cancer. 2023 Jan;1878(1):188847. doi: 10.1016/j.bbcan.2022.188847. Epub 2022 Dec 11.

Abstract

This systematic review and meta-analysis study investigates the predictive and prognostic value of PIK3CA mutations for HER2-positive breast cancer treated with tyrosine kinase inhibitors (TKIs). A search of the Medline, Embase, and Cochrane Library databases yielded 17 eligible studies (1706 patients). In 10 neoadjuvant studies, the pathological complete response rate was significantly higher in wild-type PIK3CA (WT) patients than in mutated PIK3CA (MT) patients (OR = 0.45; 95% CI = 0.31-0.65; P < 0.001). In five metastasis studies, the pooled objective response rate was significantly higher in WT patients than in MT patients (OR = 0.40; 95% CI = 0.23-0.70; P = 0.001). Four metastasis studies indicated that PIK3CA mutations had a marginally significant relationship with poor progression-free survival and overall survival. Thus, PIK3CA mutations have predictive value for the treatment response of early/advanced-stage HER2-positive breast cancer treated with TKI-containing regimens.

Keywords: HER2-positive breast cancer; PIK3CA mutations; Tyrosine kinase inhibitors.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / genetics
  • Class I Phosphatidylinositol 3-Kinases / genetics
  • Female
  • Humans
  • Neoadjuvant Therapy
  • Prognosis
  • Receptor, ErbB-2 / genetics
  • Trastuzumab
  • Tyrosine Kinase Inhibitors

Substances

  • Trastuzumab
  • Tyrosine Kinase Inhibitors
  • Receptor, ErbB-2
  • Class I Phosphatidylinositol 3-Kinases
  • PIK3CA protein, human