Prognostic Impact of Discordance in Hormone Receptor Status Between Primary and Recurrent Sites in Patients With Recurrent Breast Cancer

Shiino, Sho; Kinoshita, Takayuki; Yoshida, Masayuki; Jimbo, Kenjiro; Asaga, Sota; Takayama, Shin; Tsuda, Hitoshi

doi:10.1016/j.clbc.2016.05.014

Cited by 45 publications

(37 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 Meanwhile, based on Cox univariate and multivariate analyses, the loss of HR expression and conversion to TNBC at the recurrence site can be independent prognostic factors for recurrent breast cancer. 24 This is consistent with our results.…”

Section: Discussionsupporting

confidence: 94%

<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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 94%

<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

View full text Add to dashboard Cite

show abstract

“…A recent study comparing matched tissue from primary breast cancer and different metastases (only 3% brain metastases) showed the highest discordance in PgR and lowest in Her2/neu. A significantly worse clinical outcome was shown in patients who either lost their positive hormone-receptor status or converted to triple-negative in the metastasis (12). Some studies have shown a significant increase of brain metastasis-free interval for patients with positive ER, while others see no influence (13,14).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, metastatic lesions are treated according to this receptor phenotype. Since several studies indicate a change in receptor expression between the primary tumor and subsequent metastasis in different organs (9)(10)(11)(12), one could expect a significant risk that targeted therapies would only hit the primary tumor and not the subsequent metastasis, if changes in the expression pattern occur. There is little data about conversion rates of brain metastases (12) which often are the most limiting ones for the patient's prognosis.…”

Section: Abstract Background/aim: Knowing the Molecular Footprint Ofmentioning

confidence: 99%

Discordance and Conversion Rates of Progesterone-, Estrogen-, and HER2/neu-Receptor Status in Primary Breast Cancer and Brain Metastasis Mainly Triggered by Hormone Therapy

Timmer

Werner

Röhn

et al. 2017

View full text Add to dashboard Cite

In summary, receptor conversion is frequent during disease progression. Therefore, the receptor status of the primary tumor is invalid for planning a therapy targeted against brain metastases, especially after hormone-therapy. In these cases, new tissue collection by biopsy or resection is mandatory for the selection of adequate therapeutic targets and accurate decision-making for systemic therapies.

show abstract

“…A recent analysis showed discordance rates for ER, PR, and HER2 expression between primary and metastatic tumors of 18%, 26%, and 7% of patients, respectively (30). Outcome was significantly worse in patients whose HR-positive tumors became HR-negative in the recurrent sites compared to patients whose tumors did not change.…”

Section: On the Horizonmentioning

confidence: 99%

New Strategies in Metastatic Hormone Receptor–Positive Breast Cancer: Searching for Biomarkers to Tailor Endocrine and Other Targeted Therapies

Jankowitz

Oesterreich

Lee

et al. 2017

Clinical Cancer Research

View full text Add to dashboard Cite

While major advances in our understanding of the molecular underpinnings of hormone receptor-positive (HR-positive) breast cancer have led to new therapies that have substantially improved in patient outcomes, endocrine–resistant disease still remains a leading cause of breast cancer mortality. Comprehensive molecular profiling of breast cancers has highlighted tremendous tumor heterogeneity, and analysis of paired primary and metastatic tumors has shown the evolution that can occur during acquired resistance to systemic therapies. Novel techniques for monitoring tumor load under treatment pressure, including “liquid biopsy” techniques, such as circulating free tumor DNA (cfDNA) and circulating tumor cells(CTCs), have shown promise as biomarkers to direct treatment without invasive tumor biopsies. However, more research is needed to deepen our understanding of breast cancer alterations under treatment pressure in order to reveal mechanisms of drug resistance and apply precision medicine in biomarker-driven clinical trials.

show abstract

Prognostic Impact of Discordance in Hormone Receptor Status Between Primary and Recurrent Sites in Patients With Recurrent Breast Cancer

Cited by 45 publications

References 28 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>

Discordance and Conversion Rates of Progesterone-, Estrogen-, and HER2/neu-Receptor Status in Primary Breast Cancer and Brain Metastasis Mainly Triggered by Hormone Therapy

New Strategies in Metastatic Hormone Receptor–Positive Breast Cancer: Searching for Biomarkers to Tailor Endocrine and Other Targeted Therapies

Contact Info

Product

Resources

About