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Gampenrieder SP, Dezentjé V, Lambertini M, de Nonneville A, Marhold M, Le Du F, Cortés Salgado A, Alpuim Costa D, Vaz Batista M, Chic Ruché N, Tinchon C, Petzer A, Blondeaux E, Del Mastro L, Targato G, Bertucci F, Gonçalves A, Viret F, Bartsch R, Mannsbart C, Deleuze A, Robert L, Saavedra Serrano C, Gion Cortés M, Sampaio-Alves M, Vitorino M, Pecen L, Singer C, Harbeck N, Rinnerthaler G, Greil R. Influence of HER2 expression on prognosis in metastatic triple-negative breast cancer-results from an international, multicenter analysis coordinated by the AGMT Study Group. ESMO Open 2023; 8:100747. [PMID: 36563519 PMCID: PMC10024122 DOI: 10.1016/j.esmoop.2022.100747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is associated with poor prognosis, and new treatment options are urgently needed. About 34%-39% of primary TNBCs show a low expression of human epidermal growth factor receptor 2 (HER2-low), which is a target for new anti-HER2 drugs. However, little is known about the frequency and the prognostic value of HER2-low in metastatic TNBC. PATIENTS AND METHODS We retrospectively included patients with TNBC from five European countries for this international, multicenter analysis. Triple-negativity had to be shown in a metastatic site or in the primary breast tumor diagnosed simultaneously or within 3 years before metastatic disease. HER2-low was defined as immunohistochemically (IHC) 1+ or 2+ without ERBB2 gene amplification. Survival probabilities were calculated by the Kaplan-Meier method, and multivariable hazard ratios (HRs) were estimated by Cox regression models. RESULTS In total, 691 patients, diagnosed between January 2006 and February 2021, were assessable. The incidence of HER2-low was 32.0% [95% confidence interval (CI) 28.5% to 35.5%], with similar proportions in metastases (n = 265; 29.8%) and primary tumors (n = 425; 33.4%; P = 0.324). The median overall survival (OS) in HER2-low and HER2-0 TNBC was 18.6 and 16.1 months, respectively (HR 1.00; 95% CI 0.83-1.19; P = 0.969). Similarly, in multivariable analysis, HER2-low had no significant impact on OS (HR 0.95; 95% CI 0.79-1.13; P = 0.545). No difference in prognosis was observed between HER2 IHC 0/1+ and IHC 2+ tumors (HR 0.89; 95% CI 0.69-1.17; P = 0.414). CONCLUSIONS In this large international dataset of metastatic TNBC, the frequency of HER2-low was 32.0%. Neither in univariable nor in multivariable analysis HER2-low showed any influence on OS.
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Affiliation(s)
- S P Gampenrieder
- Salzburg Cancer Research Institute- Center for Clinical Cancer and Immunology Trials, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - V Dezentjé
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Lambertini
- Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino Genova, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, Università di Genova, Genova, Italy
| | - A de Nonneville
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - M Marhold
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - F Le Du
- Département d'oncologie médicale, Centre Eugène-Marquis, Rennes, France
| | - A Cortés Salgado
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - D Alpuim Costa
- Haematology and Oncology Department, CUF Oncologia, Lisbon, Portugal; NOVA Medical School, (NMS), Faculdade de Ciências Médicas (FCM), Lisbon, Portugal; Centro de Medicina Subaquática e Hiperbárica (CMSH), Marinha Portuguesa, Lisbon, Portugal
| | - M Vaz Batista
- Oncology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - N Chic Ruché
- Department of Medical Oncology, Hospital Clínic Barcelona, Barcelona, Spain
| | - C Tinchon
- Department for Haemato-Oncology, LKH Hochsteiermark-Leoben, Leoben, Austria
| | - A Petzer
- Internal Medicine I for Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern-Elisabethinen, Linz, Austria
| | - E Blondeaux
- U.O. Epidemiology Unit, IRCCS Ospedale Policlinico San Martino Genova, Genova, Italy
| | - L Del Mastro
- Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino Genova, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, Università di Genova, Genova, Italy
| | - G Targato
- Dipartimento di Oncologia, Ospedale Santa Maria della Misericordia di Udine, Udine, Italy
| | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - A Gonçalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - F Viret
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - R Bartsch
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - C Mannsbart
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - A Deleuze
- Département d'oncologie médicale, Centre Eugène-Marquis, Rennes, France
| | - L Robert
- Département d'oncologie médicale, Centre Eugène-Marquis, Rennes, France
| | - C Saavedra Serrano
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Gion Cortés
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Sampaio-Alves
- Faculdade de Medicina, Universidade do Porto (FMUP), Oporto, Portugal
| | - M Vitorino
- Oncology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - L Pecen
- Institute of Computer Science, Czech Academy of Sciences, Praha, Czech Republic; Faculty of Medicine in Pilsen - Charles University, Pilsen, Czech Republic
| | - C Singer
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - N Harbeck
- Breast Center, Department of Gynecology and Obstetrics, Comprehensive Cancer Center of the Ludwig-Maximilians-University, Munich, Germany
| | - G Rinnerthaler
- Salzburg Cancer Research Institute- Center for Clinical Cancer and Immunology Trials, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - R Greil
- Salzburg Cancer Research Institute- Center for Clinical Cancer and Immunology Trials, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.
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Houvenaeghel G, de Nonneville A, Cohen M, Classe JM, Reyal F, Mazouni C, Chopin N, Martinez A, Daraï E, Coutant C, Colombo PE, Gimbergues P, Chauvet MP, Azuar AS, Rouzier R, Tunon de Lara C, Murraciole X, Agostini A, Gonçalves A, Lambaudie E. Abstract P2-08-08: Isolated ipsilateral local recurrence of breast cancer: Predictive factors and prognostic impact. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Tumour features associated with isolated invasive breast cancer ipsilateral local recurrence (ILR) after breast conservative treatment (BCT) and consequences on overall survival (OS) are still debated. The aim of our study was to examine predictive factors of isolated ILR after BCT with in sano resection and whole breast irradiation as well as the impact of such an ILR on overall survival in a large multi-institutional cohort.
Methods
Patients were retrospectively identified from a large cohort of 23,375 consecutive patients who underwent BCT for invasive breast cancer in 16 cancer centres. End-points were ILR rate and OS. The impact of ILR on OS was assessed through multivariate analysis by logistic regression and Cox model, adjusted on ERs/Grade status (ERs+/Grade 1, ERs+/Grade 2, ERs+/Grade 3 and ERs-) and then on tumour subtypes.
Results
Of 15,570 patients, ILR rate was 3.1%. Cumulative ILR rates differed according to ERs/grade (ERs+/Grade2: HR=1.42, p=0.010; ERs+/Grade3: HR=1.41, p=0.067; ERs-: HR=2.14, p<0.0001), endocrine therapy (HR=2.05, p<0.0001) and age<40-years old (HR=2.28, p=0.005) in multivariate analysis. When multivariate analysis was adjusted on tumour subtype, the latter was the only independent factor. OS-after-ILR was significantly different according to ILR-free intervals (HR=4.96 for ILR-free interval between 2-5-years and HR=9.00 when <2-years, in comparison with ≥5-years).
Impact of free interval time on OS among patients with ILR and among all patients p-valueHRInfSupILRno ILR 1 <2 years0.0172.2551.1594.388 2-5 years0.0012.451.423.89 ≥5 years0.1030.5550.2741.126Tumor subtypesLuminal A G1 1 Luminal A G20.0031.4311.1321.810 Triple negative<0.00012.6992.0553.544 Luminal B ER-<0.00013.1952.4144.229 Luminal B ER+0.021.6081.0762.401 HER2+<0.00012.2791.4523.579
Conclusion
ERs/Grade status, lack of endocrine therapy and tumour subtypes predict isolated ILR risk in patients treated with BCT. Short ILR-free-intervals represent a strong pejorative factor for OS. These results may help selecting initial treatment as well as tailoring ILR systemic chemotherapy.
Citation Format: Houvenaeghel G, de Nonneville A, Cohen M, Classe J-M, Reyal F, Mazouni C, Chopin N, Martinez A, Daraï E, Coutant C, Colombo P-E, Gimbergues P, Chauvet M-P, Azuar A-S, Rouzier R, Tunon de Lara C, Murraciole X, Agostini A, Gonçalves A, Lambaudie E. Isolated ipsilateral local recurrence of breast cancer: Predictive factors and prognostic impact [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-08.
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Affiliation(s)
- G Houvenaeghel
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - A de Nonneville
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - M Cohen
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - J-M Classe
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - F Reyal
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - C Mazouni
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - N Chopin
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - A Martinez
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - E Daraï
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - C Coutant
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - P-E Colombo
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - P Gimbergues
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - M-P Chauvet
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - A-S Azuar
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - R Rouzier
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - C Tunon de Lara
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - X Murraciole
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - A Agostini
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - A Gonçalves
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
| | - E Lambaudie
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut René Gauducheau, Site Hospitalier Nord, St. Herblain, France; Institut Curie, Paris, France; Institut Gustave Roussy, Paris, France; Centre Léon Bérard, Lyon, France; Centre Claudius Regaud, Toulouse, France; Hôpital Tenon, Paris, France; Centre Georges François Leclerc, Dijon, France; Centre Val d'Aurelles, Montpellier, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Oscar Lambret, Lille, France; Hôpital de Grasse, Grasse, France; Hôpital René Huguenin, Saint Cloud, France; Institut Bergonié, Bordeaux, France; Hôpital de la Timone, Marseille, France; Hôpital de la Conception, Service de Gynécologie Obstétrique, Marseille, France
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de Nonneville A, Gonçalves A, Cohen M, Reyal F, Classe JM, Giard S, Colombo PE, Muracciole X, Chopin N, Lambaudie E, Houvenaeghel G. Abstract P1-13-04: Impact of hormone receptor status in HER2-Positive early breast cancer in the trastuzumab era: Results of a National multi-institutional study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Recent updated analysis of the HERA (HERceptin Adjuvant) trial indicate that tumor hormone receptor status (HR)remains a major determinant of outcome in HER2-positive (HER2+) early breast cancer (BC) patients, with higher rates of recurrence and death in women with HR-negative (HR-) disease, even after 11 years' median follow-up. Furthermore, data reported from the HERA trial suggest that the timing of recurrences is different, with an initial higher frequency of disease-free survival (DFS) events in patients with HR- disease than those with HR-positive disease (HR+). No evidence of a different trastuzumab efficacy according to the HR of the primary tumor was found. In this study, we examined the impact of HR on outcome in a large, multicenter, “real-world”, retrospective cohort of HER2+ early breast cancer patients
Methods: HER2+ BC were retrospectively identified from a large cohort of 23,375 consecutive patients who underwent primary surgery at 17 French centers between Dec 1987 and Jan 2014. A multivariate Cox model was built including age, tumor size, SBR grade, lymphovascular invasion, lymph node involvement, hormonal receptors status, adjuvant chemotherapy, adjuvant hormone therapy, trastuzumab, radiotherapy and type of surgery.
Results: A total of 1308 cases were identified, including 829 (63%) HR+ and 479 (47%) HR- patients. Median follow-up was 52 months (range 0 to 201). Compared with HR+, HR- patients had significantly smaller tumors (37 vs. 31% ≤ 10mm, p=0.027; information for multifocal tumors was not available), with higher SBR grade (58 vs. 40% grade 3, p<0.001) and had more lymph nodes involvement (41 vs. 32% pN+, p=0.001). HR- patients were more frequently treated by mastectomy (41 vs. 31%, p<0.001), received more trastuzumab (63 vs. 53%, p<0.001) and less radiotherapy (85 vs. 89%, p=0.020). Endocrine therapy was administered in 90% (744) of HR+ patients. No other significant difference in patient, tumor or treatment characteristics was found. HR status impacted DFS, metastasis free-survival (MFS) and BC-Specific survival (BC-SS) (hazard ratios: 0.46 [0.32-0.66]; p<0.001, 0.52 [0.33-0.82]; p=0.004 and 0.56 [0.34-0.90]; p=0.017, respectively), log-rank test) in overall population with higher rates of recurrence and death in women with HR- disease. In multivariate analysis, lymph node involvement and use of trastuzumab but not HR status impacted significantly DFS, MFS and BC-SS. Considering patients by treatment groups (with or without trastuzumab), HR status was not predictive of survival outcomes in the trastuzumab group, as opposed to the group without trastuzumab. Regarding the timing of recurrences, we observed an increased tendency for later relapse in patients with HR+ disease compared with HR- disease, for both DFS and MFS events.
Conclusions: Our results suggest that HR status remains a major determinant of outcome in HER2+ BC, including the timing of recurrence. Yet, this prognostic impact appears to be mitigated by trastuzumab-based adjuvant treatment.
Citation Format: de Nonneville A, Gonçalves A, Cohen M, Reyal F, Classe JM, Giard S, Colombo PE, Muracciole X, Chopin N, Lambaudie E, Houvenaeghel G. Impact of hormone receptor status in HER2-Positive early breast cancer in the trastuzumab era: Results of a National multi-institutional study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-13-04.
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Affiliation(s)
- A de Nonneville
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - A Gonçalves
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - M Cohen
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - F Reyal
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - JM Classe
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - S Giard
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - PE Colombo
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - X Muracciole
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - N Chopin
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - E Lambaudie
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
| | - G Houvenaeghel
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France; Institut Curie, Paris, France; Institut René Gauducheau, St Herblain, France; Centre Oscar Lambret, Lille, France; CRLC Val-d'Aurelle, Montpellier, France; Hôpital de la Timone, Marseille, France; Centre Léon Bérard, Lyon, France
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