PMID- 36810001
OWN - NLM
STAT- MEDLINE
DCOM- 20230224
LR  - 20230225
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Feb 21
TI  - Distribution, dynamic evolution, and clinical outcomes of patients with advanced 
      breast cancer according to HER2 expression.
PG  - 173
LID - 10.1186/s12885-023-10634-7 [doi]
LID - 173
AB  - BACKGROUND: Novel antibody‒drug conjugates (ADC) have shown great efficacy in 
      HER2-low advanced breast cancer. However, the clinical features of HER2-low 
      disease still need to be clarified. The current study aims to evaluate the 
      distribution and dynamic change in HER2 expression in patients with disease 
      recurrence and the clinical outcome of those patients. METHODS: Patients with 
      pathologically diagnosed relapsed breast cancer between 2009 and 2018 were 
      included. Samples were considered HER2-zero when the immunohistochemistry (IHC) 
      score was 0, HER2-low when the IHC score was 1 + or 2 + with negative 
      fluorescence in situ hybridization (FISH) results, and HER2-positive when the IHC 
      score was 3 + or the FISH results were positive. Breast cancer-specific survival 
      (BCSS) was compared among the three HER2 groups. Changes in HER2 status were also 
      evaluated. RESULTS: A total of 247 patients were included. Among recurrent 
      tumors, 53 (21.5%) were HER2-zero, 127 (51.4%) were HER2-low, and 67 (27.1%) were 
      HER2-positive. The HER2-low subtype represented 68.1% of the HR-positive breast 
      cancer group and 31.3% of the HR-negative group (P < 0.001). This three-group 
      classification of HER2 status was prognostic in advanced breast cancer 
      (P = 0.0011), with HER2-positive patients having the best clinical outcome after 
      disease recurrence (P = 0.024), while only marginal survival advantages were 
      observed in HER2-low patients versus HER2-zero patients (P = 0.051). In the 
      subgroup analysis, the survival difference was observed only in patients with 
      HR-negative recurrent tumors (P = 0.0006) or with distant metastasis 
      (P = 0.0037). The overall discordance rate of HER2 status between primary and 
      recurrent tumors was 38.1%, with 25 (49.0%) primary HER2-zero patients and 19 
      (26.8%) HER2-positive patients shifting to HER2-low at recurrence. CONCLUSION: 
      Nearly half of the advanced breast cancer patients had HER2-low disease, which 
      indicates a poorer prognosis than HER2-positive disease and marginally better 
      outcomes than HER2-zero disease. During disease progression, one-fifth of tumors 
      convert to HER2-low entities, and the corresponding patients may benefit from ADC 
      treatment.
CI  - (c) 2023. The Author(s).
FAU - Shi, Qin
AU  - Shi Q
AD  - Department of Breast and Thyroid Surgery, Hangzhou Linping District Maternal and 
      child Care Hospital, Hangzhou, China.
FAU - Yu, Jing
AU  - Yu J
AD  - Department of General Surgery, Comprehensive Breast Health Center, Ruijin 
      Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, 
      200025, Shanghai, China.
FAU - Liu, Deyue
AU  - Liu D
AD  - Department of Breast and Thyroid Surgery, Shanghai General Hospital, Shanghai 
      JiaoTong University School of Medicine, Shanghai, China.
FAU - Ren, Fang
AU  - Ren F
AD  - Department of Breast and Thyroid Surgery, Hangzhou Linping District Maternal and 
      child Care Hospital, Hangzhou, China.
FAU - Wu, Jiayi
AU  - Wu J
AD  - Department of General Surgery, Comprehensive Breast Health Center, Ruijin 
      Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, 
      200025, Shanghai, China. pinkscorpio@163.com.
FAU - Shen, Kunwei
AU  - Shen K
AD  - Department of General Surgery, Comprehensive Breast Health Center, Ruijin 
      Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, 
      200025, Shanghai, China. kwshen@medmail.com.cn.
LA  - eng
GR  - 201840323/Shanghai Municipal Health and Family Planning Commission/
GR  - 14411950200/Science and Technology Commission of Shanghai Municipality/
GR  - 81772797/National Natural Science Foundation of China/
PT  - Journal Article
DEP - 20230221
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
RN  - 0 (Biomarkers, Tumor)
SB  - IM
MH  - Humans
MH  - *Receptor, ErbB-2/metabolism
MH  - *Biomarkers, Tumor/metabolism
MH  - In Situ Hybridization, Fluorescence/methods
MH  - Neoplasm Recurrence, Local
MH  - Prognosis
PMC - PMC9942407
OTO - NOTNLM
OT  - Breast cancer
OT  - Clinical outcome
OT  - Disease recurrence
OT  - Evolution
OT  - HER2-low
COIS- The authors declare that they have no competing interest.
EDAT- 2023/02/23 06:00
MHDA- 2023/02/25 06:00
PMCR- 2023/02/21
CRDT- 2023/02/22 14:20
PHST- 2022/10/09 00:00 [received]
PHST- 2023/02/13 00:00 [accepted]
PHST- 2023/02/22 14:20 [entrez]
PHST- 2023/02/23 06:00 [pubmed]
PHST- 2023/02/25 06:00 [medline]
PHST- 2023/02/21 00:00 [pmc-release]
AID - 10.1186/s12885-023-10634-7 [pii]
AID - 10634 [pii]
AID - 10.1186/s12885-023-10634-7 [doi]
PST - epublish
SO  - BMC Cancer. 2023 Feb 21;23(1):173. doi: 10.1186/s12885-023-10634-7.