Predictors of pathological complete response to neoadjuvant treatment and changes to post-neoadjuvant HER2 status in HER2-positive invasive breast cancer
| Autor: | Ayaka Katayama, Rebecca Millican-Slater, Nahla M Badr, Tetsunari Oyama, Karim Eldib, Sho Shiino, Grace Callagy, Cian Martyn, Islam M. Miligy, Elena Provenzano, Ian O. Ellis, Dave Purnell, Cecily Quinn, Michael S. Toss, Sarah E Pinder, Emad A. Rakha, Ciara Murray, Andrew H S Lee, Colin A. Purdie, Abeer M Shaaban, Sasagu Kurozumi |
|---|---|
| Přispěvatelé: | Katayama, Ayaka [0000-0002-8667-158X], Toss, Michael S [0000-0002-9077-3984], Provenzano, Elena [0000-0003-3345-3965], Purdie, Colin [0000-0002-1258-4010], Pinder, Sarah E [0000-0003-4167-8910], Ellis, Ian [0000-0001-5292-8474], Apollo - University of Cambridge Repository |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology Adult medicine.medical_specialty Pathology Receptor ErbB-2 medicine.medical_treatment Breast Neoplasms Article Pathology and Forensic Medicine Targeted therapy 03 medical and health sciences 0302 clinical medicine Breast cancer Targeted therapies Neoadjuvant treatment Internal medicine medicine Biomarkers Tumor Humans Chemotherapy skin and connective tissue diseases Pathological neoplasms Complete response Aged Aged 80 and over business.industry Middle Aged medicine.disease Neoadjuvant Therapy 030104 developmental biology Treatment Outcome Chemotherapy Adjuvant 030220 oncology & carcinogenesis In situ hybridisation Immunohistochemistry Female business |
| Zdroj: | Modern Pathology |
| ISSN: | 1530-0285 |
| Popis: | The response of human epidermal growth factor receptor2 (HER2)- positive breast cancer (BC) patients to anti-HER2 targeted therapy is significant. However, the response is not uniform and a proportion of HER2-positive patients do not respond. This study aims to identify predictors of response in the neoadjuvant treatment and to assess the discordance rate of HER2 status between pre- and post-treatment specimens in HER2-positive BC patients. The study group comprised 500 BC patients treated with neoadjuvant chemotherapy (NACT) and/or neoadjuvant anti-HER2 therapy and surgery who had tumours that were 3+ or 2+ with HER2 immunohistochemistry (IHC). HER2 IHC 2+ tumours were classified into five groups by fluorescence in situ hybridisation (FISH) according to the 2018 ASCO/CAP guidelines of which Groups 1, 2 and 3 were considered HER2 amplified. Pathological complete response (pCR) was more frequent in HER2 IHC 3+ tumours than in HER2 IHC 2+/HER2 amplified tumours, when either in receipt of NACT alone (38% versus 13%; p = 0.22) or neoadjuvant anti-HER2 therapy (52% versus 20%; p < 0.001). Multivariate logistic regression analysis showed that HER2 IHC 3+ and histological grade 3 were independent predictors of pCR following neoadjuvant anti-HER2 therapy. In the HER2 IHC 2+/HER2 amplified tumours or ASCO/CAP FISH Group 1 alone, ER-negativity was an independent predictor of pCR following NACT and/or neoadjuvant anti-HER2 therapy. In the current study, 22% of HER2-positive tumours became HER2-negative by IHC and FISH following neoadjuvant treatment, the majority (74%) HER2 IHC 2+/HER2 amplified tumours. Repeat HER2 testing after neoadjuvant treatment should therefore be considered. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink