HER2-low breast cancer and response to neoadjuvant chemotherapy: a population-based cohort study.
In: Pathology, Jg. 56 (2024-04-01), Heft 3, S. 334-342
academicJournal
Zugriff:
About half of breast cancers (BC) without amplification of the human epidermal growth factor receptor 2 (HER2) have a low HER2 protein expression level (HER2-low). The clinical impact of HER2-low and the response to neoadjuvant chemotherapy (NAC) is unclear. This study aimed to assess the association between HER2-low BC and pathological response to NAC. Data from the Dutch Pathology Registry were collected for 11,988 BC patients treated with NAC between 2014 and 2022. HER2-low BC was defined as an immunohistochemical score of 1+ or 2+ and a negative molecular reflex test. We compared clinicopathological features of HER2-0 versus HER2-low BC and assessed the correlation between HER2 status and the pathological complete response (pCR) rate after NAC, including overall survival. Among hormone receptor (HR)-positive tumours, 67% (n=4,619) were HER2-low, compared to 47% (n=1,167) in the HR-negative group. Around 32% (n=207) of patients had a discordant HER2 status between the pre-NAC biopsy and the corresponding post-NAC resection, within which 87% (n=165) changed from HER2-0 to HER2-low or vice versa. The pCR rate was significantly lower in HER2-low BC compared to HER2-0 BC within the HR-positive group (4% versus 5%; p=0.022). However, the absolute difference was limited, so the clinical relevance is questionable. In HR-negative cases, the difference in pCR was not significant (32% versus 34%; p=0.266). No significant difference in overall survival was observed between HER2-low and HER2-0 tumours, regardless of hormone receptor status. The antibody-drug conjugate trastuzumab deruxtecan (T-DXd) has improved survival outcomes of patients with HER2-low metastatic BC. The finding that one-third of the patients in this study had a discordant HER2 status between the pre-NAC biopsy and the post-NAC resection specimen could impact clinical decision-making should T-DXd be used in early BC treatment.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Titel: |
HER2-low breast cancer and response to neoadjuvant chemotherapy: a population-based cohort study.
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Autor/in / Beteiligte Person: | Baez-Navarro, X ; van Bockstal MR ; Jager, A ; van Deurzen CHM |
Zeitschrift: | Pathology, Jg. 56 (2024-04-01), Heft 3, S. 334-342 |
Veröffentlichung: | Jan. 2011- : London : Lippincott Williams & Wilkins ; <i>Original Publication</i>: [Surry Hills, NSW, etc., Modern Medicine, etc.], 2024 |
Medientyp: | academicJournal |
ISSN: | 1465-3931 (electronic) |
DOI: | 10.1016/j.pathol.2023.10.022 |
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