HER2-low status and response to neoadjuvant chemotherapy in HER2 negative early breast cancer

被引：128

作者：

de Moura Leite, Luciana ^{[1
]}

Cesca, Marcelle Goldner ^{[1
]}

Tavares, Monique Celeste ^{[1
]}

Santana, Debora Maciel ^{[1
]}

Saldanha, Erick Figueiredo ^{[1
]}

Guimaraes, Paula Tavares ^{[1
]}

Sa, Daniella Dias Silva ^{[1
]}

Simoes, Maria Fernanda Evangelista ^{[1
]}

Viana, Rafael Lima ^{[1
]}

Rocha, Francisca Giselle ^{[1
]}

Loose, Simone Klog ^{[1
]}

Silva, Sinara Figueiredo ^{[1
]}

Pirolli, Rafaela ^{[1
]}

Fogassa, Camilla Albina Zanco ^{[1
]}

Mattos, Bruna Raphaeli Silva ^{[1
]}

Campos, Fernando Augusto Batista ^{[1
]}

Sanches, Solange Moraes ^{[1
]}

de Lima, Vladmir Claudio Cordeiro ^{[1
]}

Ponde, Noam Falbel ^{[1
]}

机构：

[1] AC Camargo Canc Ctr, Dept Med Oncol, Sao Paulo, SP, Brazil

来源：

BREAST CANCER RESEARCH AND TREATMENT | 2021年 / 190卷 / 01期

关键词：

HER2; HER2-low breast cancer; Antibody-drug conjugates; Trastuzumab-deruxtecan; Trastuzumab-duocarmazine; AMERICAN-SOCIETY; CLINICAL ONCOLOGY/COLLEGE; PROGNOSTIC-FACTOR; IMMUNOHISTOCHEMISTRY; RECOMMENDATIONS; AMPLIFICATION; EXPRESSION; SURVIVAL; IMPACT;

D O I：

10.1007/s10549-021-06365-7

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose Knowledge on whether low expressions of HER2 have prognostic impact in early-stage breast cancer (BC) and on its response to current chemotherapy protocols can contribute to medical practice and development of new drugs for this subset of patients, changing treatment paradigms. This study aims to evaluate the impact of HER2-low status on response to neoadjuvant chemotherapy (NACT) and survival outcomes in early-stage HER2-negative BC. Methods Records from all BC patients treated with NACT from January 2007 to December 2018 in a single cancer center were retrospectively reviewed. HER2-negative (immunohistochemistry [IHC] 0, + 1, or + 2 non-amplified by in situ hybridization [ISH]) patients were included. HER2-low was defined by IHC + 1 or + 2 ISH non-amplified and HER2-0 by IHC 0. The coprimary objectives were to compare pathological complete response (pCR) and relapse-free survival (RFS) between luminal/HER2-low versus luminal/HER2-0 populations and between triple negative (TNBC)/HER2-low versus TNBC/HER2-0. Results In total, 855 HER2-negative patients were identified. The median follow-up was 59 months. 542 patients had luminal subtype (63.4%) and 313 had TNBC (36.6%). 285 (33.3%) were HER2-low. Among luminal patients, 145 had HER2 IHC + 1 (26.8%) and 91 had IHC + 2/ISH non-amplified (16.8%). In TNBC, 36 had HER2 IHC + 1 (11.5%) and 13 had IHC + 2/ISH non-amplified (4.2%). Most patients had locally advanced tumors, regardless of subtype or HER2-low status. For luminal disease, pCR was achieved in 13% of HER2-low tumors versus 9.5% of HER2-0 (p = 0.27). Similarly, there was no difference in pCR rates among TNBC: 51% versus 47% in HER2-low versus HER2-0, respectively (p = 0.64). HER2-low was also not prognostic for RFS, with 5-year RFS rates of 72.1% versus 71.7% (p = 0.47) for luminal HER2-low/HER2-0, respectively, and 75.6% versus 70.8% (p = 0.23) for TNBC HER2-low/HER2-0. Conclusion Our data does not support HER2-low as a biologically distinct BC subtype, with no prognostic value on survival outcomes and no predictive effect for pCR after conventional NACT.

引用

页码：155 / 163

页数：9

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