Metastatic site patterns by intrinsic subtype and HER2DX in early HER2-positive breast cancer.

Autor:	Dieci MV; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Oncology 2, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy., Conte P; Veneto Oncology Network, Padova, Italy., Bisagni G; Department of Oncology and Advanced Technologies, Oncology Unit, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy., Bartolini S; Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy., Frassoldati A; Clinical Oncology, Department of Translational Medicine and for Romagna, S. Anna University Hospital, Ferrara, Italy., Generali D; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.; Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, Cremona, Italy., Piacentini F; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Griguolo G; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Oncology 2, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy., Tagliafico E; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy.; Department of Laboratory Medicine and Pathology, Diagnostic Hematology and Clinical Genomics Unit, Modena University Hospital, Modena, Italy., Brasó Maristany F; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain., Chic N; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.; Department of Medical Oncology, Hospital Clinic of Barcelona, Spain., Paré L; Reveal Genomics, Barcelona, Spain., Miglietta F; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Oncology 2, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy., Vicini R; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., D'Amico R; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Balduzzi S; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Prat A; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.; Department of Medical Oncology, Hospital Clinic of Barcelona, Spain.; Reveal Genomics, Barcelona, Spain.; Department of Medicine, University of Barcelona, Barcelona, Spain., Guarneri V; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Oncology 2, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.
Jazyk:	angličtina
Zdroj:	Journal of the National Cancer Institute [J Natl Cancer Inst] 2024 Jan 10; Vol. 116 (1), pp. 69-80.
DOI:	10.1093/jnci/djad179
Abstrakt:	Background: Even with contemporary treatment strategies, more than 10% of HER2-positive early stage breast cancer patients may experience distant metastasis as first event during follow-up. Tools for predicting unique patterns of metastatic spread are needed to plan personalized surveillance. We evaluated how molecular heterogeneity affects the pattern of distant relapse in HER2-positive breast cancer. Methods: A total of 677 HER2-positive stage I-III breast cancer patients from ShortHER trial, Cher-LOB trial, and 2 institutional cohorts were included. PAM50 molecular subtypes and research-based HER2DX scores were evaluated. The cumulative incidence of distant relapse as the first event (any site and site specific) was evaluated using competing risk analysis. Median follow-up was 8.4 years. Tests of statistical significance are 2-sided. Results: Stage III and high HER2DX risk score identified patients at the highest risk of distant relapse as first event (10-year incidence 24.5% and 19.7%, respectively). Intrinsic molecular subtypes were associated with specific patterns of metastatic spread: compared with other subtypes, HER2-enriched tumors were more prone to develop brain metastases (10-year incidence 3.8% vs 0.6%, P = .005), basal-like tumors were associated with an increased risk of lung metastases (10-year incidence 11.1% vs 2.6%, P = .001), and luminal tumors developed more frequently bone-only metastases (10-year incidence 5.1% vs 2.0%, P = .042). When added to stage or HER2DX risk score in competing risk regression models, intrinsic subtype maintained an independent association with site-specific metastases. Conclusions: The integration of intrinsic molecular subtypes with stage or HER2DX risk score predicts site-specific metastatic risk in HER2-positive breast cancer, with potential implications for personalized surveillance and clinical trials aimed at preventing site-specific recurrence. (© The Author(s) 2023. Published by Oxford University Press.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu