{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:11:06Z","timestamp":1789053066768,"version":"build-2803163510"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_med-2026-1525_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Neoadjuvant chemotherapy with dual HER2 blockade is the standard of care for early-stage HER2-positive breast cancer. However, the role of anthracyclines remains controversial. This meta-analysis aimed to evaluate the efficacy and safety of neoadjuvant dual HER2 blockade combined with anthracycline-containing vs. anthracycline-free chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1525_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A literature search was conducted across PubMed, EMBASE, and the Cochrane Library. Eligible studies included patients with resectable stage I-III HER2-positive breast cancer receiving neoadjuvant dual HER2 blockade with either an anthracycline-containing (A-based) or anthracycline-free (non-A) chemotherapy regimen. Standard meta-analytic methods using a random-effects or fixed-effect model were applied according to heterogeneity\u00a0(I\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1525_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven articles met the inclusion criteria. The addition of anthracyclines to dual HER2 blockade therapy (DHBT) did not significantly improve the pCR rate (OR, 1.07; 95\u202f% CI, 0.81\u20131.43; p=0.62), composite DFS\/EFS\/PFS (HR, 0.50; 95\u202f% CI, 0.18\u20131.38; p=0.18), or overall survival (OS) (HR, 0.77; 95\u202f% CI, 0.39\u20131.51; p=0.45). The incidence of cardiac adverse events did not differ significantly between the A-based and non-A groups (OR, 0.96; 95\u202f% CI, 0.31\u20132.91; p=0.94). No significant difference was observed in the incidence of LVEF decline\u00a0\u226510\u202f% from baseline to &lt;50\u202f% between the A-based and non-A groups (OR, 1.47; 95\u202f% CI, 0.79\u20132.77; p=0.23). Notably, the non-A group had a significantly higher incidence of grade\u00a0\u22653 diarrhea (OR, 0.60, favoring the A-based group; 95\u202f% CI, 0.38\u20130.95; p=0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1525_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In resectable HER2-positive breast cancer, neoadjuvant DHBT without anthracyclines achieves pCR rates non-inferior to A-based regimens, with no early survival detriment observed. While short-term cardiotoxicity is unremarkable, grade\u00a0\u22653 diarrhea occurs more frequently with non-A approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/med-2026-1525","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:57:58Z","timestamp":1789052278000},"source":"Crossref","is-referenced-by-count":0,"title":["Neoadjuvant anthracycline-containing vs. anthracycline-free chemotherapy with dual HER2 blockade in HER2-Positive breast cancer: a Systematic Review and meta-analysis"],"prefix":"10.1515","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7037-648X","authenticated-orcid":false,"given":"Wenwen","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1379-4177","authenticated-orcid":false,"given":"Qingyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5373-8098","authenticated-orcid":false,"given":"Zhiguo","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1864-8537","authenticated-orcid":false,"given":"Xiaoyan","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2079-0348","authenticated-orcid":false,"given":"Yajing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6231-111X","authenticated-orcid":false,"given":"Yuzhi","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4896-7790","authenticated-orcid":false,"given":"Ruohui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8119-9514","authenticated-orcid":false,"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2095-5995","authenticated-orcid":false,"given":"Yunjie","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6504-3384","authenticated-orcid":false,"given":"Xinyi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9733-1433","authenticated-orcid":false,"given":"Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"2026091014575056170_j_med-2026-1525_ref_001","doi-asserted-by":"crossref","unstructured":"Schlam, I, Swain, SM. 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