HER2 status results in an unstable switch from primary to recurrent breast cancer.

IF 2 4区 医学 Q3 ONCOLOGY Neoplasma Pub Date : 2024-08-01 DOI:10.4149/neo_2024_240229N89
Anjie Zhu, Nan Wang, Zehui Yun, Xiaoran Liu, Xu Liang, Ying Yan, Bin Shao, Hanfang Jiang, Lijun Di, Guohong Song, Huiping Li
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Abstract

Accurately distinguishing HER2-2+ tumors from HER2-0/1+ tumors via immunohistochemistry (IHC) is still very challenging. HER2 IHC 2+ is considered to indicate moderate expression and is easier to distinguish, with more reliable results in previous and current clinical practice. We focused on HER2-2+ patients and evaluated the switch in HER2 status between primary and paired recurrent disease patients to evaluate the discordance of HER2-2+ expression. We included patients who were HER2-2+ of primary or rebiopsy tumor samples, to evaluate the evolution of HER2-2+ expression. In the cohort with a total of 159 patients with HER2-2+ expression in either primary tumor or locoregional/distant metastasis samples, 44.0% had HER2-2+ in primary tumor and 88.8% in recurrent disease. Among patients with primary and recurrent HER2-2+ breast cancers, 18.5% and 15.2% of the patients, respectively, had HER2 gene amplification via ISH. The overall rate of discordance in HER2 IHC results was 67.1%. Among primary HER2-2+ patients, 74.6% were maintained in the HER2-2+ cohort at the recurrence. The discordance was mostly driven by patients switching from HER2-2+ to HER2-1+ (64.7%). Among HER2-2+ recurrent patients, discordance in the IHC results was mostly driven by switching from HER2-0 to HER2-2+ (47.1%). When HER2-low was added to the analysis, the overall rate of HER2 discordance was 40.4%. The proportion of patients with discordant HER2 expression was significantly greater among HR-positive patients than negative patients (44.1% vs. 21.7%, p=0.062). HER2 expression in primary and recurrent breast cancer samples was highly unstable. Discordance was more frequently observed in the HR-positive population.

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HER2 状态导致原发性乳腺癌向复发性乳腺癌的不稳定转换。
通过免疫组化(IHC)准确区分HER2-2+肿瘤和HER2-0/1+肿瘤仍然非常具有挑战性。HER2 IHC 2+ 被认为表示中度表达,更容易区分,在以前和现在的临床实践中结果更可靠。我们以 HER2-2+ 患者为研究对象,评估了原发性和配对复发性疾病患者之间 HER2 状态的转换,以评价 HER2+ 表达的不一致性。我们还纳入了原发或复查肿瘤样本中HER2-2+的患者,以评估HER2-2+表达的演变情况。在原发肿瘤或局部/远处转移样本中均有HER2-2+表达的159例患者中,44.0%的患者在原发肿瘤中HER2-2+,88.8%的患者在复发疾病中HER2-2+。在原发性和复发性HER2-2+乳腺癌患者中,分别有18.5%和15.2%的患者通过ISH检测发现HER2基因扩增。HER2 IHC结果的总体不一致率为67.1%。在原发性 HER2+ 患者中,74.6% 的患者在复发时仍保持在 HER2+ 组群中。不一致的主要原因是患者从HER2-2+转为HER2-1+(64.7%)。在HER2-2+复发患者中,IHC结果不一致的主要原因是从HER2-0转为HER2-2+(47.1%)。如果将HER2-low加入分析,HER2不一致的总体比例为40.4%。HR阳性患者中HER2表达不一致的比例明显高于阴性患者(44.1% vs. 21.7%,P=0.062)。原发性和复发性乳腺癌样本中的HER2表达高度不稳定。在HR阳性人群中更常观察到不一致性。
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来源期刊
Neoplasma
Neoplasma 医学-肿瘤学
CiteScore
5.40
自引率
0.00%
发文量
238
审稿时长
3 months
期刊介绍: The journal Neoplasma publishes articles on experimental and clinical oncology and cancer epidemiology.
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