Comparative efficacy and safety of targeted therapy and immunotherapy for HER2-positive breast cancer: a systematic review and network meta-analyses.

Background: In recent years, novel therapies targeting specific molecular pathways and immunotherapies have exhibited promising outcomes for treating human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Our work aimed to assess the effectiveness and safety of these emerging treatment regimens for this disease. Material and methods: We systematically searched databases including PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials their inception to August 2023 to identify relevant randomized controlled trials (RCTs). The quality of eligible RCTs was evaluated with the Cochrane risk-of-bias tool, version 2 (RoB2). Investigated outcomes encompassed progression-free survival (PFS), overall survival (OS), disease-free survival (DFS), pathologic complete remission (pCR), and adverse events (AEs). They were expressed as hazard ratio (HR) with 95% conference intervals (CI) or risk ratio (RR) with 95% CI. Results: Our analysis identified a total of 28 RCTs suitable for inclusion in the NMA. Regarding the PFS, all these treatment regimens exhibited comparable effectiveness. In terms of OS, Capecitabine+Trastuzumab, Lapatinib+Trastuzumab and Pyrotinib+Capecitabine exhibited better effect compared to other treatments. Regarding pCR and AEs, all these treatment regimens exhibited comparable effectiveness, especially Lapatinib+Trastuzumab and Pyrotinib+Capecitabine. Conclusion: Our study highlights the prominent role of targeted therapies and immunotherapies in treating HER2-positive breast cancer. The efficacy of trastuzumab-containing regimens was superior to other treatment options, while maintaining a comparable safety profile. Based on these findings, trastuzumab-containing regimens emerge as a preferable and recommended choice in clinical practice for managing HER2-positive breast cancer. Systematic Review Registration: PROSPERO, identifier CRD42023414348.

Distinguishing the Effects of the Space-Charge Layer and Interfacial Side Reactions on Li10GeP2S12-Based All-Solid-State Batteries with Stoichiometric-Controlled LiCoO2.

All-solid-state lithium batteries (ASSLBs) with high volumetric energy density and enhanced safety are considered one of the most promising next-generation batteries. Elucidating the capacity-fading mechanism caused by the space-charge layer (SCL) and the interfacial side reaction (ISR) is crucial for the future development of high-energy-density ASSLBs with a longer cycle life. Here, a systematic study to probe the electrochemical performance of Li10GeP2S12-based ASSLBs with stoichiometric-controlled LixCoO2 was performed with the aid of density functional theory (DFT) calculations, X-ray photoelectron spectroscopy (XPS), focused ion beam-field emission scanning electron microscopy (FIB-SEM), and solid-state nuclear magnetic resonance (NMR) spectroscopy. We discovered that the overstoichiometric Li1.042CoO2 shows a high capacity at first cycle with the smallest overpotential, but the capacity gradually decreases, which is ascribed to the weak SCL effect and strong interfacial side reactions. On the contrary, the lithium-deficient Li0.945CoO2 achieves the best cycling stability with a very low capacity associated with the strongest SCL effect and weak interfacial side reactions. The SCL effect is indeed coupled with ISR, which eventually leads to capacity fading in long-term operation. We believe that the new insights gained from this work will accelerate the future development of LiCoO2/LGPS-based ASSLBs with both a mitigated SCL effect and a longer cycle life.