Efficacy evaluation of neoadjuvant chemotherapy in patients with HER2-low expression breast cancer: A real-world retrospective study

Tang, Lingfeng; Zhenghang, LI; Jiang, Lixian; Shu, Xiujie; Xu, Yingkun; Liu, Shengchun

doi:10.3389/fonc.2022.999716

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…7,8 Subsequent studies have been conducted to explore the differences in response to neoadjuvant chemotherapy (NAC), as well as in DFS of BC patients with HER2-low or HER2-0 status. [9][10][11][12][13][14][15][16] However, these results have been inconsistent and even conflicting.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the pCR Rate and DFS Among Breast Cancer Patients with Different Hormone Receptor and HER2 Statuses

Jin¹,

Lan²,

Dai³

et al. 2023

BCTT

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Background: Recent studies have investigated the features of breast cancer (BC) with low human epidermal growth factor receptor 2 (HER2) expression or HER2-0 expression. However, the results were inconsistent. In this study, we investigated the differences in the pathological complete response (pCR) rate and disease-free survival (DFS) between HER2-low and HER2-0 BC patients and between subgroups. Methods: HER2-negative BC patients who received neoadjuvant chemotherapy between January 2013 and December 2019 in our hospital were retrospectively reviewed. First, the pCR rate and DFS were compared between HER2-low and HER2-0 patients and among different hormone receptor (HR) and HER2 statuses. Subsequently, DFS was compared between different HER2 status populations with or without pCR. Finally, a Cox regression model was used to identify the prognostic factors. Results: Overall, 693 patients were selected: 561 were HER2-low, and 132 were HER2-0. Between the two groups, there were significant differences in N stage (P = 0.008) and HR status (P = 0.007). No significant difference in the pCR rate (12.12% vs 14.39%, P = 0.468) or DFS was observed, independent of HR status. HR+/HER2-low patients had a significantly worse pCR rate (P < 0.001) and longer DFS (P < 0.001) than HR-/HER2-low or HER2-0 patients. In addition, a longer DFS was found in HER2-low patients versus HER2-0 patients among those who did not achieve pCR. Cox regression showed that N stage and HR status were prognostic factors in the overall and HER2-low populations, while no prognostic factor was found in the HER2-0 group. Conclusion:This study suggested that HER2 status is not associated with the pCR rate or DFS. Longer DFS was found only among patients who did not achieve pCR in the HER2-low versus HER2-0 population. We speculated that the interaction of HR and HER2 might have played a crucial role in this process.

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Section: Introductionmentioning

confidence: 99%

Comparison of the pCR Rate and DFS Among Breast Cancer Patients with Different Hormone Receptor and HER2 Statuses

Jin¹,

Lan²,

Dai³

et al. 2023

BCTT

Self Cite

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“…The pCR rates of both groups in our previous study of the patients from 2012-2016 increased, which may be due to the bene ts of drug improvement. 12 In analysis of 5-year DFS, HER2-enriched patients without targeted therapy had the highest recurrence rate. However, anti-HER2 targeted therapy is widely used in neoadjuvant therapy and postoperative systemic treatment, and the pCR rate and DFS rate of patients can be signi cantly improved.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 According to the analysis of clinical characteristics and chemosensitivity, HER2-low breast cancer, accounts for 70% of breast cancer, may be different from HER2-negative (IHC 0) breast cancer considered as a new subtype. [9][10][11][12] Neoadjuvant chemotherapy (NACT), utilized before surgery, is mainly used for the management of patients with locally advanced breast cancer. 13 Generally, estrogen receptor (ER)-positive breast cancer has poor sensitivity to chemotherapy among various breast cancer subtypes.…”

Section: Introductionmentioning

confidence: 99%

Prognosis and Influencing Factors of ER-positive, HER2-low Patients with Residual Diseases after Neoadjuvant Chemotherapy: A Retrospective Study

Tang

Jiang

Jin

et al. 2023

Preprint

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Background Previously, we found that estrogen receptor (ER)-positive, HER2-low patients is insensitive to neoadjuvant chemotherapy (NACT). And the outcomes of patients with residual diseases were worse than that of patients who achieved pathological complete response (pCR) after NACT. The purpose of this study is to explore the prognosis and influencing factors of these patients . Methods A total of 618 ER-positive breast cancer patients who received thrice-weekly standard NACT were enrolled, including 411 ER-positive, HER2-low cases. Clinicopathological features before and after NACT of these patients were collected. Univariate and multivariate COX regression analyses were used to find the independent factors of 5-year disease-free survival (DFS). Results Of the ER-positive, HER2-low patients, 49 cases (11.9%) attained pCR after NACT. A significant survival difference was shown in patients with or without residual diseases after NACT. Level changes in immunohistochemical markers and tumor stages before and after NACT were significant. According to univariate and multivariate analyses, we found that significant associations between cN_stage (P = 0.002), ER (P = 0.002) and Ki67 (P = 0.023) expression before NACT with 5-year DFS, while pT_stage (P = 0.015), pN_stage (P = 0.029), ER (P = 0.020) and Ki67 (P ༜0.001) after NACT was related to 5-year DFS in ER-positive, HER2-low patients with residual diseases. Conclusion Our study suggested that pre- and post-NACT high proliferation, low ER expression level and advanced stage both were associated with poor prognosis, which provides a reference for developing long-term treatment strategies for ER-positive, HER2-low patients with residual diseases in the future.

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The Effect of HER2-Low Status on Pathological Complete Response and Survival in Triple-Negative Breast Cancer: A Systemic Review and Meta-Analysis

Ergün

Akagündüz

Karaçin

et al. 2023

Clinical Breast Cancer

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Efficacy evaluation of neoadjuvant chemotherapy in patients with HER2-low expression breast cancer: A real-world retrospective study

Cited by 5 publications

References 33 publications

Comparison of the pCR Rate and DFS Among Breast Cancer Patients with Different Hormone Receptor and HER2 Statuses

Comparison of the pCR Rate and DFS Among Breast Cancer Patients with Different Hormone Receptor and HER2 Statuses

Prognosis and Influencing Factors of ER-positive, HER2-low Patients with Residual Diseases after Neoadjuvant Chemotherapy: A Retrospective Study

The Effect of HER2-Low Status on Pathological Complete Response and Survival in Triple-Negative Breast Cancer: A Systemic Review and Meta-Analysis

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