Abstract: ObjectiveTo compare the efficacy and safety of trastuzumab versus the combination of trastuzumab and lapatinib added to neoadjuvant chemotherapy in HER2positive breast cancer.  MethodsWe searched PubMed, MEDLINE, The Cochrane Library, Web of Science, CNKI, Wanfang datebase and the abstracts of major international conferences in recent 5 years to identify randomized controlled trials which met the inclusion and exclusion criteria. Study selection and analyses were undertaken according to the Cochrane Handbook. Metaanalysis was performed using RevMan 5.0 software.  ResultsFour trials were identified with 779 eligible patients. The results of metaanalyses showed that the rate of pathological complete response was significantly higher in the group receiving rastuzumab and tlapatinib than that in the group with trastuzumab alone (53.3%vs 38.8%，RR=1.39, 95 %CI： 1.201.63; P<0.001). No statistical differences were observed in regarding adverse events among patients receiving trastuzumab or the combination of trastuzumab and lapatinib, except the grade ⅢⅣ diarrhea (2.2%vs 25.6%，RR=11.54, 95%CI： 5.6923.41; P<0.001).  ConclusionThe combination of trastuzumab and lapatinib added to neoadjuvant chemotherapy in HER2positive breast cancer is more effective, without more adverse reactions except diarrhea; it ia an effective and safe treatment.

Key words: Breast neoplasms, Neoadjuvant therapy, Metaanalysis, Trastuzumab, Lapatinib