Therapy response and prognosis of patients with early breast cancer with low positivity for hormone receptors- An analysis of 2765 patients from neoadjuvant clinical trials

被引：53

作者：

Villegas, Sonia L. ^{[1
,2
,3
,4
]}

Nekljudova, Valentina ^{[5
]}

Pfarr, Nicole ^{[6
]}

Engel, Jutta ^{[7
]}

Untch, Michael ^{[8
]}

Schrodi, Simone ^{[7
]}

Holms, Frank ^{[9
]}

Ulmer, Hans U. ^{[10
]}

Fasching, Peter A. ^{[11
]}

Weber, Karsten E. ^{[5
]}

Albig, Christian ^{[6
]}

Heinrichs, Clemens ^{[12
]}

Marme, Frederik ^{[13
]}

Hartmann, Arndt ^{[14
]}

Hanusch, Claus ^{[15
]}

Schmitt, Wolfgang D. ^{[1
,2
,3
,4
]}

Huober, Jens ^{[16
]}

Lederer, Bianca ^{[5
]}

van Mackelenbergh, Marion ^{[17
]}

Tesch, Hans ^{[18
]}

Jackisch, Christian ^{[19
]}

Rezai, Mahdi ^{[20
]}

Sinn, Peter ^{[21
]}

Sinn, Bruno, V ^{[1
,2
,3
,4
]}

Hackmann, John ^{[22
]}

Kiechle, Marion ^{[23
]}

Schneeweiss, Andreas ^{[24
]}

Weichert, Wilko ^{[6
]}

Denkert, Carsten ^{[1
,2
,3
,4
,25
,26
]}

Loibl, Sibylle ^{[5
]}

机构：

[1] Charite Univ Med Berlin, Inst Pathol, Berlin, Germany

[2] Free Univ Berlin, Berlin, Germany

[3] Humboldt Univ, Berlin, Germany

[4] Berlin Inst Hlth, Berlin, Germany

[5] GBG Forsch GmbH, German Breast Grp, Martin Behaim Str 12, D-63263 Neu Isenburg, Germany

[6] Tech Univ Munich, Inst Gen & Surg Pathol, Munich, Germany

[7] Ludwig Maximilians Univ LMU, Inst Med Informat Proc Biometry & Epidemiol IBE, Univ Hosp Munich, Munich Canc Registry MCR,Bavarian Canc Registry R, Munich, Germany

[8] HELIOS Klin, Breast Canc Ctr, Berlin, Germany

[9] St Barbara Klin, Hamm Heessen, Germany

[10] Mittelbaden Hosp, Karlsruhe, Germany

[11] Univ Erlangen Nurnberg, Dept Gynecol, Erlangen, Germany

[12] Inst Pathol, Duren, Germany

[13] Univ Hosp Mannheim, Dept Gynecol, Mannheim, Germany

[14] Univ Erlangen Nurnberg, Inst Pathol, Erlangen, Germany

[15] Frauenklin, Rotkreuzklinikum, Munich, Germany

[16] Univ Ulm, Dept Gynecol, Ulm, Germany

[17] Schleswig Holstein Univ Hosp, Clin Obstet & Gynaecol, Kiel, Germany

[18] Bethanien Hosp Frankfurt, Oncol Practice, Frankfurt, Germany

[19] Sana Klinikum Offenbach, Offenbach, Germany

[20] Luisenkrankenhaus, Dusseldorf, Germany

[21] Heidelberg Univ, Inst Pathol, Heidelberg, Germany

[22] Marien Hosp Witten, Dept Gynecol, Witten, Germany

[23] Tech Univ Munich TUM, Comprehens Canc Ctr Munich CCCM, Dept Gynecol & Obstet, Klinikum Rechts Isar, Munich, Germany

[24] Heidelberg Univ, Natl Ctr Tumorerkrankungen, Heidelberg, Germany

[25] Philipps Univ Marburg, Inst Pathol, Marburg, Germany

[26] Univ Hosp Marburg UKGM, Marburg, Germany

来源：

EUROPEAN JOURNAL OF CANCER | 2021年 / 148卷

关键词：

Breast neoplasms; Breast cancer; Mammary cancer; ER-negative PR-negative HER2-negative breast cancer; Triple-negative breast cancer; Oestrogen receptors; Progesterone receptors; Hormone-dependent neoplasms; Neoadjuvant therapy; Cancer biomarkers; INTERNATIONAL EXPERT CONSENSUS; LIGAND-BINDING ASSAY; PREDICTING RESPONSE; ESTROGEN-RECEPTORS; ADJUVANT BREAST; ER; CHEMOTHERAPY; IMMUNOHISTOCHEMISTRY; HIGHLIGHTS; GUIDELINES;

D O I：

10.1016/j.ejca.2021.02.020

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim: To evaluate HER2-negative breast cancer (BC) with a low hormone receptor (HR) expression, with regard to pathological complete response (pCR) and survival, in comparison to triple-negative BC (TNBC) and strong HR-positive BC. Methods: We compared negative [oestrogen (ER) and progesterone receptor (PR) <1%], low positive (ER and/or PR 1-9%) and strong-positive (ER or PR 10-100%) HR-expression in neoadjuvant clinical trial cohorts (n = 2765) of BC patients. End-points were disease-free survival (DFS), distant-disease free survival (DDFS) and overall survival (OS). We performed RNA sequencing on available tumour tissue samples from patients with low-HR expression (n = 38). Results: Ninety-four (3.4%) patients had low HR-positive tumours, 1769 (64.0%) had strong HR-positive tumours, and 902 (32.6%) had TNBC. There were no significant differences in pCR rates between women with low HR-positive tumours (27.7%) and women with TNBC (35.5%). DFS and DDFS were also not different [for DFS, hazard ratio 1.26, 95%-CI (confidence interval) : 0.87-1.83, log-rank test p = 0.951; for DDFS, hazard ratio 1.17, 95%-CI: 0.78-1.76, log-rank test p = 0.774]. Patients with strong HR-positive tumours had a significantly lower pCR rate (pCR 9.4%; odds ratio 0.38, 95%-CI: 0.23-0.63), but better DFS (hazard ratio 0.48, 95%-CI: 0.33-0.70) and DDFS (hazard ratio 0.49, 95%-CI: 0.33-0.74) than patients with low HR-positive tumours. Molecular subtyping (RNA sequencing) of low HR-positive tumours classified these predominantly into a basal subtype (86.8%). Conclusion: Low HR-positive, HER2-negative tumours have a similar clinical behaviour to TNBC showing high pCR rates and poor survival and also a basal-like gene expression signature. Patients with low HR-positive tumours should be regarded as candidates for therapy strategies targeting TNBC. ? 2021 Elsevier Ltd. All rights reserved.

引用

页码：159 / 170

页数：12

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