Comparative study of receptor expression diversity between primary and recurrent lesions in patients with metastatic breast cancer.

Erdem, Gökmen Umut; Özdemir, Nuriye; Şahin, Süleyman; Demi̇rci, Nebi̇ Serkan; Karataş, Fatih; Bozkaya, Yakup; Aytekin, Aydın; Sever, Ali; Zengi̇n, Nurullah; Altundag, M. K.

doi:10.1200/jco.2016.34.15_suppl.e12062

Cited by 12 publications

(14 citation statements)

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“…Overall, the discordance rates (and discordance-rate orders of the three receptors) observed in this study were similar to those in previous reports; [4][5][6] as frequently reported, losses of receptor expression exceeded the gains. 7,8 According to most studies, PR has the highest discordance rate, followed by ER and HER2. Few reports have suggested that HER2 ranks second and ER third.…”

Section: Discussionmentioning

confidence: 99%

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

Yang¹,

Li²,

Li³

et al. 2020

OTT

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These authors contributed equally to this work Background: Hormone receptor (HR) and human epidermal growth factor receptor (HER2) discordance between primary and metastatic breast cancer lesions is common. However, its impact on long-term survival remains unclear. We aimed to determine the prognostic value of this discordance in patients with metastaticf breast cancer (MBC). Methods: A total of 270 patients with MBC who were underwent re-biopsy of progressive metastases at Zhejiang Cancer Hospital from January 1, 2012 to December 31, 2015 with patients consent and then review their primary tumors pathological findings. The HR and HER2 status in both primary and progressive metastatic lesions was determined by immunohistochemistry and/or fluorescence in situ hybridization. The discordance rates were correlated with the clinicopathologic characteristics, metastatic lesions, salvage treatment, and survival analysis in this population. Results: A total of 142 (52.6%) MBC patients were diagnosed with discordant HR and HER2 status. Alterations in estrogen receptor (ER), progesterone receptor (PR), and HER2 status were observed in 20.70%, 37.78%, and 11.48% cases, respectively. Chemotherapy (P=0.0192) and endocrine therapy (P=0.048) significantly affected the conversion of HR status. Endocrine therapy was positively correlated with PR discordance (P=0.002), while ER discordance was associated with adjuvant chemotherapy (P=0.031). Survival analysis showed that ER status alterations between primary and metastatic lesions were associated with overall survival (P=0.002). The clinical prognosis was significantly worse with HR losses than with persistent HR positivity (P=0.023). In Cox multivariate analysis, the loss of HR expression and conversion to triple negative were independent prognostic indicators. Conclusion: Discordance in HR status between primary and metastatic lesions may impact the prognosis of MBC, and HR conversion has independent prognostic value.

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Section: Discussionmentioning

confidence: 99%

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

Yang¹,

Li²,

Li³

et al. 2020

OTT

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“…Furthermore, it has shown that discordant cases have poorer survival which has been attributed to inappropriate use of targeted therapies [8]. For example, recent studies have shown that women that switch from an initial ER-positive primary tumor to an ER-negative tumor, have a significant 48% increased risk of death, when compared to women in which the ER/PR/HER2 status at first recurrence is unknown or negative [3], [29], [30]. Unfortunately, the acquisition of fresh tissue from suspected breast cancer metastases are not always performed in routine practice.…”

Section: Discussionmentioning

confidence: 99%

Quadruple Negative Breast Cancers (QNBC) Demonstrate Subtype Consistency among Primary and Recurrent or Metastatic Breast Cancer

Angajala

Mothershed

Davis

et al. 2019

Translational Oncology

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PURPOSE: Despite the availability of current standards of care treatments for triple negative breast cancer (TNBC), many patients still die from this disease. Quadruple negative tumors, which are TNBC tumors that lack androgen receptor (AR), represent a more aggressive subtype of TNBC; however, the molecular features are not well understood. METHODS: Immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), HER2, and AR was determined in 244 primary and 630 recurrent/metastatic site biopsies. Expression was correlated with a panel of 25 cancer-related genes and proteins by IHC and in situ hybridization (ISH). RESULTS: We observed that 80.2% (65 of 81) of primary TNBC tumors and 75.7% (159 of 210) of recurrent/metastatic TNBC tumors are QNBC. Bivariate fit analysis demonstrated that QNBC (n = 224) significantly (P < .03) correlated with younger aged patients at initial biopsy compared to AR positive TNBC patients (n = 51). In paired primary tissue samples and primary to recurrent/metastatic samples, at least 70% Luminal, HER2 enriched, and QNBC subtype did not change molecular profile. But, TNBC seems to be the “unstable” subtype. Within the total cohort, discordance in molecular profiles was identified in both synchronous (20%) and asynchronous (21%) intra-individual analyses. Irrespective of sample type, (Synchronous or Asynchronous), QNBC demonstrated higher concordant than TNBC. IHC and ISH results of the cancer related genes, demonstrated that gene/protein expression differ by molecular profile: TNBC (HR-/HER2-, AR+) and QNBC (HR-/HER2-, AR-). IHC in metastatic tumors, showed that the percentage of tumors positive of EGFR were higher, while PTEN and TLE3 were lower in QNBC compared to TNBC. CONCLUSION: Standard treatment of Breast Cancer (BC) relies on reliable assessment by IHC analysis of ER, PR, and HER2. Our analyses suggest that the heterogeneity of TNBC is at least partially associated with the presence or absence of AR expression, suggesting that QNBC should be considered as a clinically relevant BC subtype. IHC analysis of AR appears to be a practical assay to determine the most aggressive TNBC subtypes and identifies tumors that could benefit from available targeted therapies.

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“…В 2017 г. G. Erdem и соавт. был проведен иммуногистохимический анализ биопсий рецидивов РМЖ у 549 пациенток [17,18]. Учитывая высокий уровень дискордантности между первичной и рецидивной опухолями по экспрессии ER, PR и HER2 (27,2; 38,6 и 14,4 % соответственно), следует обратить внимание на то, что утрата гормонположительного статуса в рецидивном очаге приводила к ухудшению показателей выживаемости.…”

Section: обзорные статьиunclassified

“…В противоположность этому выявление гормонположительного рецидива при первичной гормонотрицательной карциноме увеличивало не только пострецидивную выживаемость (с 31 до 56 мес), но и общую выживаемость (с 57 до 119 мес; р = 0,0001). Аналогичные данные были представлены при анализе экспрессии HER2: утрата HER2-положительного статуса рецидивной опухолью приводила к сокращению выживаемости после развития рецидива (с 60 до 26 мес) и общей выживаемости (с 111 до 60 мес; р = 0,009) [17,18]. В целом, в ходе ретро-и проспективных исследований на протяжении последних десятилетий было показано, что диапазон частоты расхождения ER-, PR-и HER2-статуса первичной опухоли и метастатического очага РМЖ составляет 3,2-54,0; 14,3-43,0 и 0-33 % соответственно [19][20][21][22].…”

Section: обзорные статьиunclassified

Clinical significance of changes in the expression level of markers of surrogate breast cancer subtypes in recurrent and metastatic foci (literature review)

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Хайленко

Козлов

et al. 2021

Opuholi ženskoj reproduktivnoj sistemy

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Comparative study of receptor expression diversity between primary and recurrent lesions in patients with metastatic breast cancer.

Cited by 12 publications

References 0 publications

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

Quadruple Negative Breast Cancers (QNBC) Demonstrate Subtype Consistency among Primary and Recurrent or Metastatic Breast Cancer

Clinical significance of changes in the expression level of markers of surrogate breast cancer subtypes in recurrent and metastatic foci (literature review)

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