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Pöschke P, Fasching PA, Adler W, Rübner M, Beckmann MW, Hack CC, Heindl F, Hartmann A, Erber R, Gass P. Clinical Characteristics and Prognosis of HER2-0 and HER2-Low-Positive Breast Cancer Patients: Real-World Data from Patients Treated with Neoadjuvant Chemotherapy. Cancers (Basel) 2023; 15:4678. [PMID: 37835372 PMCID: PMC10571544 DOI: 10.3390/cancers15194678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
In our study, we observed the long-term survival outcomes investigated for HER2-0 and HER2-low-positive breast cancer patients who received neoadjuvant chemotherapy. Between 1998 and 2020, 10,333 patients with primary breast cancer were treated, including 1373 patients with HER2-0 or HER2-low-positive disease with neoadjuvant chemotherapy. Descriptive analyses were performed, and logistic regression models and survival analyses were calculated for disease-free survival (DFS) and overall survival (OS). Among the 1373 patients, 930 (67.73%) had HER2-low-positive and 443 (32.27%) had HER2-0 tumors. Patients with HER2-0 tumors had a significantly better pathological complete response, 29.25% vs. 20.09%, and pathological complete response/in situ, 31.97% vs. 24.08%, than patients with HER2-low-positive tumors (p < 0.001; p = 0.003), regardless of the hormone receptor (HR) status. No statistically significant differences were observed for the HR-positive (p = 0.315; p = 0.43) or HR-negative subgroups (p = 0.573; p = 0.931). DFS and OS were significantly longer for HR-positive, HER2-low-positive patients (log-rank p = 0.02; p = 0.012). OS was significantly longer for HR-negative, HER2-0 patients (log-rank p = 0.032). No significant DFS differences were found for the HR-negative cohort (log-rank p = 0.232). For the overall cohort, no significant differences were noted between HER2-low-positive and HER2-0 patients, either for DFS (log-rank p = 0.220) or OS (log-rank p = 0.403). These results show different survival outcomes for HER2-0 and HER2-low-positive tumors relative to HR status. These different cohorts can be identified using standardized immunohistochemistry, even retrospectively.
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Affiliation(s)
- Patrik Pöschke
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Matthias Rübner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
| | - Carolin C. Hack
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
| | - Arndt Hartmann
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC-ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.H.); (R.E.)
| | - Ramona Erber
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC-ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.H.); (R.E.)
| | - Paul Gass
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander–Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (P.P.); (P.A.F.); (M.R.); (M.W.B.); (C.C.H.); (F.H.)
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Jin Y, Lan A, Dai Y, Jiang L, Liu S. Comparison of the pCR Rate and DFS Among Breast Cancer Patients with Different Hormone Receptor and HER2 Statuses. Breast Cancer (Dove Med Press) 2023; 15:327-335. [PMID: 37153867 PMCID: PMC10162099 DOI: 10.2147/bctt.s407896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/27/2023] [Indexed: 05/10/2023]
Abstract
Background Recent studies have investigated the features of breast cancer (BC) with low human epidermal growth factor receptor 2 (HER2) expression or HER2-0 expression. However, the results were inconsistent. In this study, we investigated the differences in the pathological complete response (pCR) rate and disease-free survival (DFS) between HER2-low and HER2-0 BC patients and between subgroups. Methods HER2-negative BC patients who received neoadjuvant chemotherapy between January 2013 and December 2019 in our hospital were retrospectively reviewed. First, the pCR rate and DFS were compared between HER2-low and HER2-0 patients and among different hormone receptor (HR) and HER2 statuses. Subsequently, DFS was compared between different HER2 status populations with or without pCR. Finally, a Cox regression model was used to identify the prognostic factors. Results Overall, 693 patients were selected: 561 were HER2-low, and 132 were HER2-0. Between the two groups, there were significant differences in N stage (P = 0.008) and HR status (P = 0.007). No significant difference in the pCR rate (12.12% vs 14.39%, P = 0.468) or DFS was observed, independent of HR status. HR+/HER2-low patients had a significantly worse pCR rate (P < 0.001) and longer DFS (P < 0.001) than HR-/HER2-low or HER2-0 patients. In addition, a longer DFS was found in HER2-low patients versus HER2-0 patients among those who did not achieve pCR. Cox regression showed that N stage and HR status were prognostic factors in the overall and HER2-low populations, while no prognostic factor was found in the HER2-0 group. Conclusion This study suggested that HER2 status is not associated with the pCR rate or DFS. Longer DFS was found only among patients who did not achieve pCR in the HER2-low versus HER2-0 population. We speculated that the interaction of HR and HER2 might have played a crucial role in this process.
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Affiliation(s)
- Yudi Jin
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Department of Pathology, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Ailin Lan
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Yuran Dai
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Linshan Jiang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Shengchun Liu
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Correspondence: Shengchun Liu, Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China, Email
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Horisawa N, Adachi Y, Takatsuka D, Nozawa K, Endo Y, Ozaki Y, Sugino K, Kataoka A, Kotani H, Yoshimura A, Hattori M, Sawaki M, Iwata H. The frequency of low HER2 expression in breast cancer and a comparison of prognosis between patients with HER2-low and HER2-negative breast cancer by HR status. Breast Cancer 2021; 29:234-241. [PMID: 34622383 DOI: 10.1007/s12282-021-01303-3] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The DESTINY-Breast04 clinical trial is currently investigating whether trastuzumab deruxtecan (T-DXd) is effective in HER2-low as well as HER2-positive breast cancer. This highlights the interest in treatment strategies for patients with HER2-low breast cancer. The current study was therefore designed to determine the frequency of HER2-low among all breast cancers, and to compare the prognosis of HER2-low patients with that of HER2-negative patients. METHODS We retrospectively reviewed the biological data from 4,918 of 4,977 primary breast cancer patients who attended our institute. We quantified the overall frequency of breast cancer patients with a new HER2-low subtype that was defined by an immunohistochemistry score of IHC1 + or IHC2 + /ISH-. We then compared the clinical characteristics and prognosis of HER2-low patients with that of patients who did not have HER2 amplification (HER2-0). RESULTS Low HER2 expression was found in 3169 (64.4%) patients; 2860 (58.1%) were HR-positive and 309 (6.3%) were HR-negative. Among HER2-0 patients, 681 (13.9%) were HR-positive and 157 (3.2%) were HR-negative. The HER2-0 group tended to have more poor prognostic factors than the HER2-low group, irrespective of HR status. There were no statistically significant differences between the prognosis of HER2-low and HER2-0 patients, regardless of HR status. However, patients in the HER2-low group tended to have better prognosis than those in the HER2-0 group. CONCLUSION HER2-low patients did not have a significantly different prognosis than HER2-0 patients, regardless of HR status. However, we should consider tailoring therapies for patients with HRE2-low early breast cancer according to their HR status.
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Affiliation(s)
- Nanae Horisawa
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan.
| | - Yayoi Adachi
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Daiki Takatsuka
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Kazuki Nozawa
- Department of Clinical Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Yuka Endo
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Yuri Ozaki
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Kayoko Sugino
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Ayumi Kataoka
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Haruru Kotani
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Akiyo Yoshimura
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Masaya Hattori
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-ku, Nagoya-City, Aichi, 464-8681, Japan
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