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Introduction: Tumor biological factors of breast cancer (BC) such as hormone receptor (HR) status, HER2 status, and grade can differ in the metastatic cascade from primary to lymph node (LN) metastasis and to distant metastatic tissue. Systematic data regarding therapeutic consequences are yet limited.

Methods: We conducted a prospectively planned, retrospective cohort study comparing BC phenotype in tissue from primary tumors (PTs), locoregional LN metastases, and disease recurrence (DR). HR and HER2 as well as tumor grade in PTs and DR were obtained by a database search. No centralized biomarker testing was performed. The impact of changes in tumor biological factors on post-recurrence survival (PRS) and overall survival was analyzed.

Results: PriMet comprises 635 patients (LN tissue in 142 patients). Discrepancies for HR or HER2 status between PT and DR were observed in 18.7 and 21.6% of cases, respectively. For HR status, positivity of PT and negativity of DR was seen more often (13.2%) than vice versa (5.5%). For HER2 status, negativity of the primary and positivity of DR was seen more often (14.9%) than vice versa (6.7%). Discordance was more often observed between PT and LN metastasis compared to LN versus DR. However, numbers were small. Compared to concordant non-triple-negative (TN) disease, concordant TN disease showed significantly inferior PRS.

Conclusion: We demonstrate receptor discordance to occur relatively frequently between PT, LN metastasis, and DR and to impact patient prognosis. However, clinical consequences of receptor discordance need to be drawn with caution considering clinical aspects as well as tumor biology.

Competing Interests: C. Kolberg-Liedtke has received honoraria/travel support by Phaon Scientific, Novartis, Pfizer, Celgene, Roche, AstraZeneca, Lilly, HEXAL, Amgen, Eisai, and SonoScape and has received research funding by Roche, Novartis, and Pfizer (CKL). O. Gluz has received lecture/consultancy fees from Celgene, Roche, Genomic Health, Amgen, Pfizer, Novartis, Lilly, Nanostring, Eisai, and MSD, and assistance with travel costs from Celgene, Roche, and Daiichi-Sankyo. N. Harbeck has received honoraria for lectures and/or consulting from Agendia, Amgen, Astra Zeneca, BMS, Celgene, Daiichi-Sankyo, Genomic Health, Lilly, MSD, Novartis, Odonate, Pierre Fabre, Pfizer, Roche, Sandoz/Hexal, and Seattle Genetics. R. Wuerstlein, M. Freudenberger, E. Bensmann, A. du Bois, U. Nitz, E. Pelz, M. Warm, M. Ortmann, E. Sultova, S.Y. Brucker, R.E. Kates, and T. Fehm state that they have no conflict of interest regarding the paper.

Titel:	Phenotype Discordance between Primary Tumor and Metastasis Impacts Metastasis Site and Outcome: Results of WSG-DETECT-PriMet.
Autor/in / Beteiligte Person:	Kolberg-Liedtke, C ; Wuerstlein, R ; Gluz, O ; Heitz, F ; Freudenberger, M ; Bensmann, E ; du Bois A ; Nitz, U ; Pelz, E ; Warm, M ; Ortmann, M ; Sultova, E ; Brucker, SY ; Kates, RE ; Fehm, T ; Harbeck, N
Link:	Full Text Finder (Volltext)
Zeitschrift:	Breast care (Basel, Switzerland), Jg. 16 (2021-10-01), Heft 5, S. 475-483
Veröffentlichung:	Basel : Karger, c2006-, 2021
Medientyp:	academicJournal
ISSN:	1661-3791 (print)
DOI:	10.1159/000512416
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Breast Care (Basel)] 2021 Oct; Vol. 16 (5), pp. 475-483. <i>Date of Electronic Publication: </i>2020 Dec 15. References: J Clin Oncol. 2006 Jul 1;24(19):3032-8. (PMID: 16809727) ; Oncologist. 2010;15(11):1164-8. (PMID: 21041379) ; Ann Oncol. 2009 Dec;20(12):1953-8. (PMID: 19596702) ; Crit Rev Oncol Hematol. 2012 Dec;84(3):301-13. (PMID: 22710198) ; Oncology. 2013;84(6):319-25. (PMID: 23615456) ; Breast Cancer Res Treat. 2013 Jul;140(1):93-104. (PMID: 23807420) ; Med Oncol. 2014 Oct;31(10):214. (PMID: 25216864) ; J Clin Oncol. 2012 Feb 20;30(6):587-92. (PMID: 22124102) ; Acta Oncol. 2013 Nov;52(8):1649-56. (PMID: 23327413) ; Breast Care (Basel). 2016 Aug;11(4):275-281. (PMID: 27721716) ; Clin Breast Cancer. 2018 Dec;18(6):e1251-e1259. (PMID: 30262257) ; Breast Cancer Res. 2014;16(2):205. (PMID: 25032257) ; Ann Oncol. 2009 Sep;20(9):1499-1504. (PMID: 19299408) ; Nature. 2015 Feb 12;518(7538):240-4. (PMID: 25409150) ; Asian Pac J Cancer Prev. 2015;16(10):4317-21. (PMID: 26028092) ; Cancer Treat Rev. 2012 Oct;38(6):708-14. (PMID: 22178456) ; Ann Oncol. 2013 Jan;24(1):101-8. (PMID: 23002281) ; Breast. 2012 Jun;21(3):284-8. (PMID: 22212746) ; Breast Care (Basel). 2018 Jul;13(3):209-215. (PMID: 30069182) ; Breast Cancer Res. 2010;12(6):R92. (PMID: 21059212) ; Ann Oncol. 2018 Aug 1;29(8):1634-1657. (PMID: 30032243) ; J Clin Oncol. 2007 Sep 1;25(25):3846-52. (PMID: 17679725) ; J BUON. 2017 Mar-Apr;22(2):365-376. (PMID: 28534357) Contributed Indexing: Keywords: Breast cancer; HER2; Heterogeneity; Hormone receptors; Metastases Entry Date(s): Date Created: 20211101 Latest Revision: 20220427 Update Code: 20240513 PubMed Central ID: PMC8543305

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Phenotype Discordance between Primary Tumor and Metastasis Impacts Metastasis Site and Outcome: Results of WSG-DETECT-PriMet.