Pathological complete response, long-term outcomes, and recurrence patterns in HER2-low versus HER2-zero breast cancer after neoadjuvant chemotherapy

Kang, Sora; Lee, So H.; Lee, Hee Jun; Jeong, Hyehyun; Jeong, Jae Ho; Kim, Jeong Eun; Ahn, Jin‐Hee; Jung, Kyung Hae; Gong, Gyungyub; Kim, Hak H.; Lee, Sae Byul; Lee, Jongwon; Kim, Sung‐Bae

doi:10.1016/j.ejca.2022.08.031

Cited by 52 publications

(61 citation statements)

References 18 publications

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“…For those who went neoadjuvant therapy, we concluded that, patients with HER2-0 BC showed a higher pCR rate, which is consistent with the results Kang`s study published in 2022 (Kang et al, 2022). Taken together, our current findings did not demonstrate meaningful differences in pCR rate or clinical outcomes between HER2-low and HER2-0 in multivariate analysis, which is consistent with recently published report (de Moura Leite et al, 2021).…”

Section: Discussionsupporting

confidence: 92%

Molecular characteristics and prognosis of breast cancer patients with different level of HER2 positivity after adjuvant and neoadjuvant chemotherapy

Tuluhong

Zhu

et al. 2023

European Journal of Cancer Prevention

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Purpose HER2-low breast cancer (BC) has renewed interests of researchers worldwide. Here, we aimed to investigate the clinicopathological characteristics of patients with HER2-low, HER2-0 and HER2 ultra-low BC and make conclusion. Methods We collected cases of patients who were diagnosed as BC at Jingling General hospital. Immunohistochemistry was used to redefine HER2 scores. Kaplan–Meier methods and Cox proportional hazards regression analysis were used to compare survival. Results We found that HER2-low BC was more frequent in hormone receptor (HR)–positive BC patients and was associated with fewer T3-T4, lower breast conserving surgery rate and higher adjuvant chemotherapy rate. HER2-low BC patients had better overall survival (OS) compared to HER2-0 BC in premenopausal and stage II BC. Furthermore, HER2-0 BC patients had lower Ki-67 expression levels compared to HER2-ultra low and HER2-low BC in HR–negative BC. HER2-0 BC patients also had worse OS rate compared to those with HER2-ultra low BC in HR–positive BC. Finally, HER2-0 BC patients showed a higher pathological response rate compared to those with HER2-low BC after neoadjuvant chemotherapy. Conclusions These findings suggest that HER2-low BC has distinct biology and clinical features compared to HER2-0 BC, and more investigation is needed to understand the biology of HER2-ultra low BC.

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Section: Discussionsupporting

confidence: 92%

Molecular characteristics and prognosis of breast cancer patients with different level of HER2 positivity after adjuvant and neoadjuvant chemotherapy

Tuluhong

Zhu

et al. 2023

European Journal of Cancer Prevention

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“…The prevalence of hormone receptors in tumors with HER2-low is consistent with previous data from the literature [16,17,[26][27][28][29]. We observed that patients with HER2-low breast cancer had a higher percentage of ER, PR and HR positivity and lower Ki-67 levels compared to patients with HER2-0 breast cancer.…”

Section: Discussionsupporting

confidence: 91%

“…According to Shao, Y' study [36], there is no discernible difference in prognosis between breast tumors with HER2-0 and those with HER2-low. However, other studies have shown that BC cases with low HER2 have higher 5-year overall survival (OS) and disease-free survival (DFS) rates [29]. In addition, it had also been demonstrated that there is no difference in DFS between the two groups, but the prognosis tends to be worse in hormone receptor (HR)-negative/HER2-low cases compared to HR-negative/HER2-0 [26].…”

Section: Discussionmentioning

confidence: 99%

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How is the clinical value of HER2-low expression in early breast cancer with the neoadjuvant setting: an ambidirectional cohort study.

Song

et al. 2023

Preprint

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Background: Cumulative studies supported that HER2 low is a biological subtype of breast cancer however controversial conclusions were made in different real-world studies. We explored the differences in clinical characteristics and short-term and long-term prognosis outcomes between HER2 0 and HER2 low early breast cancer patients using an ambidirectional cohort in China. Methods: Among 711 patients who first diagnosed with breast cancer between January 1, 2016 to December 31, 2020, those with neoadjuvant chemotherapy were screened. Finally, 303 patients were included in our analysis and 90 patients (29.7%) with HER2 = 0 and 213 patients (70.3%) with HER2 = 1+. Propensity score method with inverse probability of treatment weighting was applied to account for the confounders. Results from weighted Kaplan-Meier curve and log-rank test, weighted logistic and cox regression were used to compare two groups. Results: Regarding the baseline and clinical characteristics between HER2-low and HER2-0 group. Family history of caner, ER, PR, HR, Ki-67 labeling index and treatment regimens were observed different. 35% patients used EC-T/EC-P/AC-P treatment. Regarding the bpCR, ORR and rwOS, after multivariate adjustment and propensity score method, no evidence indicated any differences between two groups. Conclusions: HER2-low as a specific biological subtype remains difficult. The HER2-low expression can differ from the therapeutic value in neoadjuvant setting among early breast cancer patients. Further research on the understanding of HER2 low breast cancer is necessary.

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“…8 Some previous studies have reported better survival in HER2-low-positive breast cancer than in HER2-zero breast cancer. [9][10][11] However, there is currently limited information about HER2-low-positive breast cancer on the biological characteristics and response to neoadjuvant systemic therapy (NST) defined as systemic treatment prior to surgery. Clinicians can assess patients' sensitivity to chemotherapeutic drugs by NST, providing individualized treatment to some patients based on pathologic complete response (pCR) status to improve prognosis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinicopathological characteristics and response to neoadjuvant systemic therapy in patients with HER2-low-positive and HER2-zero breast cancer

Shi

Wan

et al. 2023

Journal of Investigative Medicine

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Previous studies have observed that human epidermal growth factor receptor 2 (HER2)-low-positive patients and HER2-zero patients have different prognoses. This study was conducted to investigate whether there are differences in clinicopathological characteristics and the response to neoadjuvant systemic therapy (NST) defined as systemic treatment prior to surgery between HER2-low-positive patients and HER2-zero patients. We retrospectively analyzed the data of patients with HER2-negative breast cancer who received NST at the First Affiliated Hospital of Nanjing Medical University from 2014 to 2021. There were 238 patients with HER2-low-positive status and 198 patients with HER2-zero status. The proportion of hormone receptor (HR)-positive patients in the HER2-low-positive group was significantly higher than that in the HER2-zero group (82.8% vs 52.0%, p < 0.001). The HER2-low-positive group had more patients with low Ki67 expression (23.9% vs 16.2%, p = 0.045), higher mastectomy rate (94.5% vs 88.9%, p = 0.031), and larger pathological tumor size (21.6 vs 17.8 mm, p = 0.028) than the HER2-zero group. However, no significant differences were found in pathologic complete response (pCR) rates between the two groups. We draw a conclusion that patients with HER2-low status and HER2-zero status were not found to have different pCR rates after NST, irrespective of HR status. However, differences were observed in some clinicopathological characteristics between the two groups.

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Pathological complete response, long-term outcomes, and recurrence patterns in HER2-low versus HER2-zero breast cancer after neoadjuvant chemotherapy

Cited by 52 publications

References 18 publications

Molecular characteristics and prognosis of breast cancer patients with different level of HER2 positivity after adjuvant and neoadjuvant chemotherapy

Molecular characteristics and prognosis of breast cancer patients with different level of HER2 positivity after adjuvant and neoadjuvant chemotherapy

How is the clinical value of HER2-low expression in early breast cancer with the neoadjuvant setting: an ambidirectional cohort study.

Comparison of clinicopathological characteristics and response to neoadjuvant systemic therapy in patients with HER2-low-positive and HER2-zero breast cancer

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