A population-based study on trajectories of HER2 status during neoadjuvant chemotherapy for early breast cancer and metastatic progression.

Autor: Boman C; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden.; Breast Center, Karolinska Comprehensive Cancer Center, Stockholm, Sweden., Liu X; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden., Eriksson Bergman L; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden.; Department of Surgery and Oncology, Capio Sankt Göran Hospital, Stockholm, Sweden., Sun W; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden.; Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden., Tranchell C; Breast Center, Karolinska Comprehensive Cancer Center, Stockholm, Sweden., Toli MA; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden., Acs B; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden.; Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden., Bergh J; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden.; Breast Center, Karolinska Comprehensive Cancer Center, Stockholm, Sweden., Foukakis T; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden.; Breast Center, Karolinska Comprehensive Cancer Center, Stockholm, Sweden., Matikas A; Karolinska Institutet, Oncology/Pathology Department, Stockholm, Sweden. alexios.matikas@ki.se.; Breast Center, Karolinska Comprehensive Cancer Center, Stockholm, Sweden. alexios.matikas@ki.se.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2024 Sep; Vol. 131 (4), pp. 718-728. Date of Electronic Publication: 2024 Jun 28.
DOI: 10.1038/s41416-024-02777-6
Abstrakt: Background: This study aimed to investigate the distribution and changes of HER2 status in untreated tumours, in residual disease and in metastasis, and their long-term prognostic implications.
Methods: This is a population-based cohort study of patients treated with neoadjuvant chemotherapy for breast cancer during 2007-2020 in the Stockholm-Gotland region which comprises 25% of the entire Swedish population. Information was extracted from the National Breast Cancer Registry and electronic patient charts to minimize data missingness and misclassification.
Results: In total, 2494 patients received neoadjuvant chemotherapy, of which 2309 had available pretreatment HER2 status. Discordance rates were 29.9% between primary and residual disease (kappa = 0.534), 31.2% between primary tumour and metastasis (kappa = 0.512) and 33.3% between residual disease to metastasis (kappa = 0.483). Adjusted survival curves differed between primary HER2 0 and HER2-low disease (p < 0.001), with the former exhibiting an early peak in risk for death which eventually declined below the risk of HER2-low. Across all disease settings, increasing the number of biopsies increased the likelihood of detecting HER2-low status.
Conclusion: HER2 status changes during neoadjuvant chemotherapy and metastatic progression, and the long-term behaviours of HER2 0 and HER2-low disease differ, underscoring the need for obtaining tissue biopsies and for extended follow-up in breast cancer studies.
(© 2024. The Author(s).)
Databáze: MEDLINE
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