Biology, prognosis and response to therapy of breast carcinomas according to HER2 score

Ménard, Sylvie; Balsari, Andrea; Tagliabue, Elda; Camerini, Tiziana; Casalini, Patrizia; Bufalino, Rosaria; Castiglioni, Fabio; Ml, Carcangiu; Gloghini, Annunziata; Scalone, Simona; Querzoli, Patrizia; Lunardi, Maria; Molino, A.; Mandarà, Marta; Mottolese, Marcella; Marandino, Ferdinando; Venturini, M.; Bighin, Claudia; Cancello, Giuseppe; Montagna, Emilia; Perrone, F.; Matteis, A. De; Sapino, Anna; Donadio, Michela; Battelli, Nicola; Santinelli, Alfredo; Pavesi, L.; Lanza, A.; Fa, Zito; Labriola, A; Aiello, R. A.; Caruso, Michele; Zanconati, Fabrizio; Mustacchi, Giorgio; Barbareschi, Mattia; Frisinghelli, M.; Russo, Rosa; Carrillo, Giovanna

doi:10.1093/annonc/mdn369

Cited by 32 publications

(24 citation statements)

References 17 publications

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“…In our study, HRC breast cancer patients with tumors displaying moderate HER2 (2C) expression had a poorer DFS but not BCSS compared with low (1C) or negative (0) HER2 expression, confirming previous findings from smaller cohort studies (Gilcrease et al 2009, Iorfida et al 2012. In other studies, HER2 (2C) was a prognostic factor only in lymph node positive breast cancer (Menard et al 2008). However, the impact of moderate HER2 (2C) expression on DFS by multivariate analysis after adjustment for other prognostic factors has been not shown yet (Menard et al 2008).…”

Section: Discussionsupporting

confidence: 90%

“…In other studies, HER2 (2C) was a prognostic factor only in lymph node positive breast cancer (Menard et al 2008). However, the impact of moderate HER2 (2C) expression on DFS by multivariate analysis after adjustment for other prognostic factors has been not shown yet (Menard et al 2008). HER2 (2C) moderate status is defined as w500 000 detectable HER2 receptors on the cell surface (Ross & Fletcher 1998) required for the activation of underlying intracellular HER2 pathways to drive tumor growth and invasiveness.…”

Section: Discussionmentioning

confidence: 99%

“…Menard et al (2008) conducted a retrospective study and were able to show that the HER2 (2C) status is associated with increased recurrence rates in patients with positive lymph-nodes. Notably, their cohort study identified 24.1% patients as HER2 (2C), whereas our cohort study identified only 12% patients as HER2 (2C).…”

Section: Discussionmentioning

confidence: 99%

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Moderate HER2 expression as a prognostic factor in hormone receptor positive breast cancer

Eggemann¹,

Ignatov²,

Burger³

et al. 2015

Endocrine-Related Cancer

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Overexpression and/or amplification of human epidermal growth factor receptor 2 (HER2) is associated with poor prognosis in breast cancer and predicts response to anti-HER2 therapy in breast cancer. The prognostic relevance of moderate expression of HER2 is unclear. Data of 9872 patients with primary nonmetastatic breast cancer from the cancer registries of Magdeburg and Halle, Germany, were analyzed retrospectively. A total of 5907 patients with complete data sets including follow-up were eligible for analysis. HER2 status was determined as recommended by international guidelines. Of 5907 patients investigated, 5023 (68.4%) had HER2 0 and 1C expression and 884 (12.0%) had HER2 (2C)/ HER2K expression. Patients with hormone receptor positive (HRC) and HER2 (2C) tumors had a shorter median disease-free survival (DFS; P!0.0001) and breast cancer specific survival (BCSS; PZ0.019) than HRC patients with HER2 (0/1C) tumors. Among patients with HRK breast cancer there was no significant difference between HER2 (2C) and HER2 (0/1C) tumors. In multivariate analysis after adjustment for other prognostic factors, HER2 (2C) status remained an unfavorable prognostic factor for DFS (hazard ratio (HR)Z1.217, 95% CIZ1.052-1.408; PZ0.008) but not for BCSS (HRZ1.045, 95% CIZ0.926-1.178; PZ0.474). The HER2 (2C) status is an unfavorable prognostic factor for survival of patients with HRC breast cancer. The impact of anti-HER2 therapy in this group of patients should be evaluated.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Moderate HER2 expression as a prognostic factor in hormone receptor positive breast cancer

Eggemann¹,

Ignatov²,

Burger³

et al. 2015

Endocrine-Related Cancer

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“…All common histopathological parameters showed highly statistically significant differences between HER2-negative and HER2-positive patients as shown in previous studies [38, 39]. For instance, HER2 overexpression has been found to correlate with several adverse prognostic parameters such as large tumor size, high grade, and steroid hormone receptor negativity [39, 40].…”

Section: Discussionsupporting

confidence: 66%

Guideline Concordant Therapy Prolongs Survival in HER2-Positive Breast Cancer Patients: Results from a Large Population-Based Cohort of a Cancer Registry

Inwald

Ortmann

Zeman

et al. 2014

BioMed Research International

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Even though randomized controlled clinical trials demonstrated improved survival by adjuvant trastuzumab treatment of HER2-positive breast cancer patients, data on its effect in clinical routine are scarce. This study evaluated the use and efficacy of trastuzumab in routine treatment of HER2-positive breast cancer patients. Data from the clinical cancer registry Regensburg (Germany) were analyzed. The present study investigated 6,991 female patients with primary invasive breast cancer. In premenopausal HER2-positive patients a considerable increase of trastuzumab therapy was observed from 58.1% in 2006 to 90.9% in 2011, whereas in postmenopausal patients trastuzumab was rather used on a constant rate of 49.1%. Best overall survival (OS) was found in HER2/steroid hormone receptor-positive patients receiving guideline concordant treatment with trastuzumab plus chemotherapy (CHT) plus antihormone therapy (AHT) with a 7-year OS rate of 96% compared to the non-trastuzumab group with a 7-year OS rate of 92%. In multivariable analysis, HER2-positive patients treated with CHT or AHT who did not get trastuzumab, had a worse 7-year OS (65%, P = 0.006 versus 79%, P = 0.017) than the control groups. This population-based study demonstrated that guideline concordant use of adjuvant trastuzumab improves OS for HER2-positive breast cancer patients treated in routine clinical care.

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“…Contrairement aux femmes plus â gé es, l'expression des ré cepteurs hormonaux (ER+) est un facteur de mauvais pronostic chez les femmes jeunes en gé né ral [36] et donc probablement chez les femmes enceintes ou allaitant aussi, alors que HER2 est un facteur de mauvais pronostic indé pendant de l'â ge, mais aucune donné e n'est disponible pour les tumeurs associé es à la grossesse [113].…”

Section: Pronosticunclassified

Prise en charge du cancer du sein infiltrant de la femme non ménopausée

2009

Oncologie

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Prise en charge du cancer du sein infiltrant de la femme non mé nopausé e Dé finition de l'é tat de mé nopause La mé nopause qui est un arrê t dé finitif des sé cré tions hormonales ovariennes est une notion importante pour le choix des thé rapeutiques d'hormonothé rapie, chez les femmes porteuses de tumeurs hormonosensibles (RH+). RECOMMANDATIONS / RECOMMENDATIONS 507Existe-t-il un profil biopathologique diffé rent ?Le jeune â ge des patientes atteintes d'un cancer du sein est reconnu comme un facteur pronostique indé pendant. Cependant, la reconnaissance d'un profil biopathologique spé cifique pourrait contribuer à amé liorer leur prise en charge.La litté rature dresse beaucoup plus spé cifiquement le profil des tumeurs des femmes de moins de 35-40 ans que celui des pré mé nopausé es entre 40-50 ans.Pour essayer d'y voir plus clair, nous allons prendre chaque facteur biopathologique et analyser sa spé cificité en fonction de l'â ge. Ne seront mentionné es que les é tudes ayant montré une diffé rence significative au sein des carcinomes invasifs (p < 0,05). TailleSur l'ensemble des é tudes comparant la taille en fonction des deux caté gories d'â ge (moins de 35/40 et entre 40 et 50 ans), les patientes les plus jeunes ont significativement les tumeurs les plus volumineuses. Cette tendance persiste pour les patientes pré sentant une mutation de BRCA1 [3,35,191]. GradeLa majorité des é tudes mentionnent un grade 3 plus fré quent pour les patientes les plus jeunes. Avec une fré quence allant de 17 à 49 % pour les patientes de moins 35/40 ans [25,29,35]. Type histologique Lobulaires-canalaires ?Les carcinomes lobulaires infiltrants sont moins fré quents chez les patientes de moins de 50 ans par opposition aux carcinomes canalaires [135].Par contre, les rares carcinomes mé dullaires (< 3 %)[180] sont observé s avec une plus grande fré quence chez les femmes de moins de 35 ans (26,1/6,6 % ; p < 0,00001). Dans cette sé rie testé e, 50 % pré sentaient une mutation de BRCA1.Composante canalaire extensive C'est dans la litté rature plus ancienne que l'on retrouve les travaux à propos de la composante canalaire extensive. Celle-ci est plus importante chez les patientes plus jeunes, ce qui se retrouve dè s le stade des tumeurs infracliniques [81,93,94,95,134,184].

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Biology, prognosis and response to therapy of breast carcinomas according to HER2 score

Abstract: The present prognostic significance of HER2 is correlated to receptor expression level and points to the need to consider HER2 2+ and HER2 3+ tumors as distinct diseases with different outcomes and specific features.

Cited by 32 publications

References 17 publications

Moderate HER2 expression as a prognostic factor in hormone receptor positive breast cancer

Moderate HER2 expression as a prognostic factor in hormone receptor positive breast cancer

Guideline Concordant Therapy Prolongs Survival in HER2-Positive Breast Cancer Patients: Results from a Large Population-Based Cohort of a Cancer Registry

Prise en charge du cancer du sein infiltrant de la femme non ménopausée

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