Clinical and pathological characteristics of HR+ breast cancer with HER2 low and HER2(0) expression: exploring endocrine therapy sensitivity.

IF 1.5 4区医学 Q4 ONCOLOGY Translational cancer research Pub Date : 2024-12-31 Epub Date: 2024-12-27 DOI:10.21037/tcr-24-1013

Xin Jin, Yun-Fei Ma, Tong-Jun Sun, Qiang Xie, Fa-Xiang Yin, Li-Gong Zhang, Yan Zhao

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Abstract

Background: The clinical significance of human epidermal growth factor receptor 2 (HER2) low and HER2(0) expression in hormone receptor-positive (HR+) breast cancer patients remains uncertain. This study aimed to explore the clinical and pathological characteristics, prognosis, and endocrine therapy (ET) sensitivity among HR+ breast cancer patients with HER2 low and HER2(0) expression.

Methods: We conducted a retrospective analysis of 390 HR+, HER2-negative breast cancer patients who underwent radical surgery at The First Affiliated Hospital of Bengbu Medical University between December 2014 and December 2017. HER2 status was classified per ASCO/CAP 2018 guidelines: tumors with an immunohistochemistry (IHC) score of 0 were defined as HER2(0), and those with a score of 1+ or 2+ with negative FISH for ERBB2 gene amplification were categorized as HER2 low. Clinical and pathological characteristics, ET sensitivity, and survival outcomes were analyzed. Primary endpoints included disease-free survival (DFS) and overall survival (OS), with ROC curve analysis employed to determine prognostic thresholds.

Results: Of the 390 HR+ breast cancer patients, 32.6% had HER2(0) expression [HER2(0) cohort] and 67.4% had HER2 low expression (HER2-low cohort). Most baseline characteristics were balanced between the two cohorts, and the HER2(0) cohort had significantly worse DFS and OS than the HER2-low cohort (both P<0.05). Within the same pN stage (pN0-2), patients with HER2 low expression had a better prognosis (all P<0.05). But at pN3, patients had worse survival outcomes (P=0.003). Patients with the IHC score >4 had significantly better OS (P<0.001) and DFS (P=0.003). No significant difference in OS and DFS was observed in the IHC score ≤4 group between cohorts (both P>0.05), whereas in the IHC score >4 group, the HER2-low cohort had better OS (P<0.001) and DFS (P=0.01).

Conclusions: Patients with HER2 low expression have distinct clinical characteristics and a better prognosis compared to those with HER2(0) expression. Our study provides further real-world evidence for personalized treatment of breast cancer patients.

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HER2低表达和HER2(0)表达的HR+乳腺癌临床病理特点：探讨内分泌治疗敏感性

背景：人表皮生长因子受体2（HER2）低表达和HER2(0)表达在激素受体阳性（HR+）乳腺癌患者中的临床意义尚不明确。本研究旨在探讨HER2低表达和HER2(0)表达的HR+乳腺癌患者的临床病理特点、预后及内分泌治疗（ET）敏感性。方法：回顾性分析2014年12月至2017年12月在蚌埠医科大学第一附属医院接受根治性手术的390例HR+、her2阴性乳腺癌患者。HER2状态根据ASCO/CAP 2018指南进行分类：免疫组织化学（IHC）评分为0的肿瘤被定义为HER2(0)， ERBB2基因扩增FISH阴性，评分为1+或2+的肿瘤被归类为HER2低。分析临床和病理特征、ET敏感性和生存结果。主要终点包括无病生存期（DFS）和总生存期（OS）， ROC曲线分析用于确定预后阈值。结果：390例HR+乳腺癌患者中，HER2(0)表达（HER2(0)队列）占32.6%，HER2低表达（HER2-low队列）占67.4%。大多数基线特征在两个队列之间是平衡的，HER2(0)队列的DFS和OS均明显差于HER2（低）队列(P4均有较好的OS (P0.05)，而在IHC评分bbbb4组中，HER2（0)低队列有较好的OS (pp)）。结论：HER2低表达患者与HER2(0)表达患者相比具有明显的临床特征和较好的预后。我们的研究为乳腺癌患者的个性化治疗提供了进一步的现实证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational cancer research ONCOLOGY-

CiteScore

2.10

自引率

0.00%

发文量

252

期刊介绍： Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.