AB040. SOH26AB_0089. Quality-of-life outcomes in human epidermal growth factor receptor-2-positive breast cancer: a systematic review and meta-analysis of randomised clinical trials
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AB040. SOH26AB_0089. Quality-of-life outcomes in human epidermal growth factor receptor-2-positive breast cancer: a systematic review and meta-analysis of randomised clinical trials

Luis Bouz Mkabaah1, Eoin Kerin1, Thomas Butler1, Matthew Davey2, Aoife Lowery1, Michael Kerin1

1Department of Surgery, The Lambe Institute for Translational Research, University of Galway, Galway, Ireland; 2Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland

Background: Targeted therapies have significantly reshaped the treatment of human epidermal growth factor receptor-2-positive (HER2+) breast cancer. In parallel with advances in survival, randomised controlled trials (RCTs) have increasingly incorporated patient-reported outcome measures (PROMs) to evaluate quality-of-life (QoL) effects. This review aimed to examine how PROMs and QoL assessments are implemented in RCTs of targeted therapies for HER2+ breast cancer and to explore whether improvements in overall survival (OS) and progression-free survival (PFS) correspond with preserved QoL.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review and meta-analysis was undertaken. Statistical analyses were performed using RStudio.

Results: Twenty-five RCTs enrolling 24,234 individuals with HER2+ breast cancer (mean age, 55.6 years) were included. CONSORT-PRO reporting scores ranged from 5 to 9 (median, 8). In the metastatic setting, antibody-drug conjugates (ADCs) significantly extended time to QoL deterioration compared with non-ADC comparators [hazard ratio (HR) =0.64; 95% confidence interval (CI): 0.49–0.83; P<0.0001] and yielded modest improvements in QoL from baseline [mean difference (MD) =2.0 points; 95% CI: 0.4–3.6; P=0.01]. Dual HER2-directed therapy similarly prolonged deterioration-free intervals (HR =0.81; 95% CI: 0.69–0.94; P=0.006). However, trial-level associations between time to deterioration and OS (P=0.73) or PFS (P=0.9) were not significant.

Conclusions: PROMs feature more prominently in modern HER2-targeted therapy trials, highlighting a growing emphasis on patient-centred evaluation. Although several treatments delay QoL decline, improvements in survival do not consistently align with QoL preservation. Future research should prioritise standardised PROM integration and long-term QoL follow-up to ensure therapeutic benefit is understood beyond traditional survival endpoints.

Keywords: Breast cancer; human epidermal growth factor receptor-2 (HER2); patient-reported outcomes; quality-of-life (QoL); targeted treatment

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab040
Cite this abstract as: Mkabaah LB, Kerin E, Butler T, Davey M, Lowery A, Kerin M. AB040. SOH26AB_0089. Quality-of-life outcomes in human epidermal growth factor receptor-2-positive breast cancer: a systematic review and meta-analysis of randomised clinical trials. Mesentery Peritoneum 2026;10:AB040.

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