HER2-low-positive breast cancer: evolution from primary tumor to residual disease after neoadjuvant treatment.

Autor: Miglietta F; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Griguolo G; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Bottosso M; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Giarratano T; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Lo Mele M; Surgical Pathology Unit, University Hospital of Padua, 35121, Padua, Italy., Fassan M; Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, 35121, Padua, Italy.; Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy., Cacciatore M; Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy., Genovesi E; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., De Bartolo D; Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, 35121, Padua, Italy., Vernaci G; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Amato O; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Porra F; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Conte P; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy., Guarneri V; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy. valentina.guarneri@unipd.it.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy. valentina.guarneri@unipd.it., Dieci MV; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128, Padova, Italy.; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128, Padova, Italy.
Jazyk: angličtina
Zdroj: NPJ breast cancer [NPJ Breast Cancer] 2022 May 20; Vol. 8 (1), pp. 66. Date of Electronic Publication: 2022 May 20.
DOI: 10.1038/s41523-022-00434-w
Abstrakt: Approximately a half of breast tumors classified as HER2-negative exhibit HER2-low-positive expression. We recently described a high instability of HER2-low-positive expression from primary breast cancer (BC) to relapse. Previous studies reporting discordance in HER2 status between baseline biopsy and residual disease (RD) in patients undergoing neoadjuvant treatment did not include the HER2-low-positive category. The aim of this study is to track the evolution of HER2-low-positive expression from primary BC to RD after neoadjuvant treatment. Patients undergoing neoadjuvant treatment with available baseline tumor tissue and matched samples of RD (in case of no pCR) were included. HER2-negative cases were sub-classified as HER2-0 or HER2-low-positive (IHC 1+ or 2+ and ISH negative). Four-hundred forty-six patients were included. Primary BC phenotype was: HR-positive/HER2-negative 23.5%, triple-negative (TN) 35%, HER2-positive 41.5%. HER2-low-positive cases were 55.6% of the HER2-negative cohort and were significantly enriched in the HR-positive/HER2-negative vs. TN subgroup (68.6% vs. 46.8%, p = 0.001 χ 2 test). In all, 35.3% of non-pCR patients (n = 291) had a HER2-low-positive expression on RD. The overall rate of HER2 expression discordance was 26.4%, mostly driven by HER2-negative cases converting either from (14.8%) or to (8.9%) HER2-low-positive phenotype. Among HR-positive/HER2-negative patients with HER2-low-positive expression on RD, 32.0% and 57.1% had an estimated high risk of relapse according to the residual proliferative cancer burden and CPS-EG score, respectively. In conclusion, HER2-low-positive expression showed high instability from primary BC to RD after neoadjuvant treatment. HER2-low-positive expression on RD may guide personalized adjuvant treatment for high-risk patients in the context of clinical trials with novel anti-HER2 antibody-drug conjugates.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz: