PMID- 34871229
OWN - NLM
STAT- MEDLINE
DCOM- 20220120
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 44
DP  - 2021 Nov 5
TI  - Pathologic complete response to neoadjuvant anti-HER2 therapy is associated with 
      HER2 immunohistochemistry score in HER2-positive early breast cancer.
PG  - e27632
LID - 10.1097/MD.0000000000027632 [doi]
LID - e27632
AB  - To evaluate whether pathologic complete response (pCR) to neoadjuvant anti-human 
      epidermal growth factor receptor 2 (HER2) therapy is dependent on the HER2 
      immunohistochemistry (IHC) score.A total of 181 HER2-positive early breast cancer 
      patients who had received neoadjuvant anti-HER2 therapy were included in this 
      study. Associations were examined between IHC score and tumor pCR status 
      (commonly defined by ypT0+ypN0, ypT0/is+ypN0, or ypT0/is).In trastuzumab-based 
      neoadjuvant-treated patients, ypT0+ypN0 was achieved in 46.0% of patients with 
      HER2 IHC 3+ tumors but only 25.0% of patients with HER2 IHC 2+/fluorescence in 
      situ hybridization (FISH)-positive tumors (P = .016). When pCR was defined as 
      ypT0/is+ypN0 or ypT0/is, 54.7% and 61.3% of patients with HER2 IHC 3+ tumors had 
      a pCR, whereas only 29.5% and 38.6% with HER2 IHC 2+/FISH-positive tumors 
      achieved pCR (P = .004 and P = .008, respectively). The association between dual 
      HER2 blockade and pCR was almost exclusively confined to HER2 IHC 3+ tumors 
      (ypT0+ypN0: 61.9% vs 38.9%, P = .013; ypT0/is+ypN0: 71.4% vs 47.4%, P = .009; and 
      ypT0/is: 81.0% vs 52.6%, P = .002) and was absent in HER2 IHC 2+/FISH-positive 
      tumors. Multivariate logistic regression revealed that HER2 IHC 3+ tumors had a 
      significantly higher probability of achieving ypT0+ypN0 (odds ratio [OR], 0.265; 
      95% confidence interval [CI], 0.109-0.645; P = .003), ypT0/is+ypN0 (OR, 0.221; 
      95% CI, 0.094-0.521; P = .001), and ypT0/is (OR, 0.254; 95% CI, 0.111-0.583; 
      P = .001) than HER2 IHC 2+/FISH-positive tumors. A significantly better pCR rate 
      was also found in patients with T1 tumors and patients with dual HER2 
      blockade.The pCR rate was highly correlated with the HER2 IHC score in 
      neoadjuvant anti-HER2 treatment. The addition of pertuzumab to a neoadjuvant 
      trastuzumab-based regimen improved pCR rates, but there was no significant 
      difference in pCR rates in the IHC 2+/FISH-positive group. This suggests that 
      HER2 IHC scores can predict the effectiveness of treatment.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Chen, Hai-Long
AU  - Chen HL
AD  - Department of Breast Surgery, the Second Affiliated Hospital of Zhejiang 
      University School of Medicine, Hangzhou, Zhejiang Province, China.
FAU - Chen, Qiang
AU  - Chen Q
FAU - Deng, Yong-Chuan
AU  - Deng YC
LA  - eng
GR  - LQ20H160031/Natural Science Foundation of Zhejiang Province/
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
RN  - P188ANX8CK (Trastuzumab)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Breast Neoplasms/*drug therapy/pathology
MH  - China
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Middle Aged
MH  - *Neoadjuvant Therapy
MH  - Receptor, ErbB-2/genetics
MH  - Retrospective Studies
MH  - Trastuzumab/*therapeutic use
MH  - Treatment Outcome
PMC - PMC8568472
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/12/07 06:00
MHDA- 2022/01/21 06:00
PMCR- 2021/11/05
CRDT- 2021/12/06 17:23
PHST- 2021/05/22 00:00 [received]
PHST- 2021/10/13 00:00 [accepted]
PHST- 2021/12/06 17:23 [entrez]
PHST- 2021/12/07 06:00 [pubmed]
PHST- 2022/01/21 06:00 [medline]
PHST- 2021/11/05 00:00 [pmc-release]
AID - 00005792-202111050-00028 [pii]
AID - MD-D-21-03759 [pii]
AID - 10.1097/MD.0000000000027632 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Nov 5;100(44):e27632. doi: 
      10.1097/MD.0000000000027632.