Prognostic implications of HER2Neu-low in metastatic breast cancer.

Hasan, Shaakir; Neubauer, Zachary; Press, Robert H.; Chhabra, Arpit; Fox, Jana; Cahlon, Oren; Bakst, Richard L.; Simone, Charles B.; Choi, J. Isabelle

doi:10.1200/jco.2022.40.16_suppl.1044

Cited by 4 publications

(7 citation statements)

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“…We evaluated 15 studies 4,10,12–14,16,18,19,22,24,25–28 ; 7 new studies 10,13,14,16,19,24,27 were included and 6 studies 3,15,20,23,29,30 were excluded from evaluation of the OS of the overall population.…”

Section: Resultsmentioning

confidence: 99%

“…In all, 14 studies 3,4,12,15,18,20,22,23,25,26,[28][29][30]32 (n = 81,486) were included to evaluate the OS of the overall population. The results demonstrated that patients with HER2-low BC had better OS than those with HER2-zero BC (HR = 0.90; 95% CI: 0.85-0.97; p = 0.003), despite considerable heterogeneity between the studies (p < 0.01; I 2 = 93%) (Figure 2(a); Table 2).…”

Section: Comparison Of Os Between Patients With Her2-low and Her2-zer...mentioning

confidence: 99%

“…OS of the hormone receptor-positive and hormone receptor-negative population. We evaluated 15 studies 4,10,[12][13][14]16,18,19,22,24,[25][26][27][28] ; 7 new studies 10,13,14,16,19,24,27 were included and 6 studies 3,15,20,23,29,30 were excluded from evaluation of the OS of the overall population.…”

Section: Comparison Of Os Between Patients With Her2-low and Her2-zer...mentioning

confidence: 99%

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The association between HER2-low expression and prognosis of breast cancer: a systematic review and meta-analysis

et al. 2023

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Background: The use of antibody–drug conjugates for the treatment of advanced-stage human epidermal growth factor receptor 2 (HER2)-low expression in breast cancer (BC) has shown prominent curative effects, which has led to increased academic interest. However, the role of HER2-low expression in the prognosis of BC remains controversial. Methods: We conducted a systematic search of the PubMed, Embase, and Cochrane library databases and several oncology conferences until 20 September 2022. We used fixed- and random-effects models to calculate odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) for overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and pathological complete response (pCR) rates. Results: Overall, 26 studies encompassing 677,248 patients were included in the meta-analysis. Patients with HER2-low BC showed significantly better OS than those with HER2-zero BC in the overall population (HR = 0.90; 95% CI: 0.85–0.97) and hormone receptor-positive population (HR = 0.98; 95% CI: 0.96–0.99), whereas no significant difference was observed in the OS of the hormone receptor-negative population ( p > 0.05). In addition, there was no significant difference in the DFS of the overall and hormone receptor-negative population ( p > 0.05), but better DFS than those with HER2-zero BC in the hormone receptor-negative population (HR = 0.96; 95% CI: 0.94–0.99). There was also no significant difference in the PFS of the overall population, hormone receptor-positive, and hormone receptor-negative population ( p > 0.05). Patients with HER2-low BC had a lower pCR rate after neoadjuvant treatment than those with HER2-zero BC. Conclusions: Compared to patients with HER2-zero BC, those with HER2-low BC had better OS in the overall population and hormone receptor-positive population, DFS in hormone receptor-positive population and lower pCR in the overall population. The biological differences between HER2-low and HER2-zero BCs, particularly in hormone receptor-positive patients, and the relationship between HER2-low expression status and prognosis need to be explored further.

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Section: Resultsmentioning

confidence: 99%

Section: Comparison Of Os Between Patients With Her2-low and Her2-zer...mentioning

confidence: 99%

Section: Comparison Of Os Between Patients With Her2-low and Her2-zer...mentioning

confidence: 99%

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The association between HER2-low expression and prognosis of breast cancer: a systematic review and meta-analysis

et al. 2023

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“…Despite the strong interest, the data on the association between HER2-low status and CDK 4/6 inhibitor efficacy are still controversial. A similar problem was present with the survival outcomes with early HER2-low breast cancer, with studies with contrasting results also available [ 39 – 42 ]. One of the main reasons regarding this issue could be the problems and variability with HER2-low case definition.…”

Section: Discussionmentioning

confidence: 84%

The association between HER2-low status and survival in patients with metastatic breast cancer treated with Cyclin-dependent kinases 4 and 6 inhibitors: a systematic review and meta-analysis

Guven,

Sahin

2024

Breast Cancer Res Treat

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Purpose The cyclin-dependent kinase (CDK) 4/6 inhibitors significantly altered the treatment landscape of hormone-positive (HR+), HER2- metastatic breast cancer (MBC). However, biomarkers predicting long-term benefit and early progression are yet to be defined. Several studies suggested the possibility of diminished efficacy in patients with HER2-low disease. Therefore, we conducted a systematic review and meta-analysis to evaluate the association between low-level HER2 expression and efficacy outcomes (PFS, OS, ORR) with CDK 4/6 inhibitors. Methods The Pubmed, Web of Science, and Scopus databases were used to systematically filter the published studies from inception to 08 August 2023 for this systemic review. Studies including MBC patients treated with CDK 4/6 inhibitors and reported survival outcomes according to HER2 expression were included. We performed the meta-analyses with the generic inverse-variance method with a fixed-effects model and used HRs with 95% two-sided CIs as the principal summary measure. Results Nine studies encompassing 2705 patients were included in the analyses. In the pooled analysis of nine studies, the risk of progression and/or death was higher in patients with HER2-low tumors compared to HER2-zero (HR: 1.22, 95% CI 1.10–1.35, p < 0.001). In the pooled analysis of five studies, although the median follow-up was short, the risk of death was higher in the HER2-low group compared to the HER2-zero group (HR: 1.22, 95% CI 1.04–1.44, p = 0.010). Conclusion The available evidence demonstrates a significantly higher risk of progression or death with CDK 4/6 inhibitors in HER2-low tumors. Further research is needed to improve outcomes in patients with HR+-HER2-low tumors.

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“…After duplicate removal and exclusion of non-relevant records, 42 studies were included in the present meta-analysis (Figure 1). Among them, 12 studies included data from patients affected by metastatic breast cancer, [15][16][17][18][19][20][21][22][23][24][25][26] 27 analysed data from patients with early breast cancer and 3 studies analysed subjects in both settings. [54][55][56] A total of 1 797 175 patients were eligible for this analysis, of whom 1 697 079 had early disease (1 118 389 HER2-low and 578 690 HER2-zero) and 100 096 had advanced disease (59 798 HER2-low and 40 298 HER2-zero).…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of HER2-low status in breast cancer: A systematic review and meta-analysis.

Molinelli

Jacobs

Agostinetto

et al. 2023

JCO

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1104 Background: HER2-Low breast cancer (BC) has been recently identified as a new therapeutic target. However, it is unclear if HER2-Low status has an independent impact on prognosis, both in metastatic and early settings. Methods: A systematic literature research of PubMed, Cochrane and conference proceedings (ASCO meetings, SABCS and ESMO congress) up to December 8, 2022 was performed to identify studies comparing survival outcomes of patients affected by HER2-Low BC vs. HER2-zero BC. HER2-Low status was defined as immunohistochemistry score 1 + or 2+ without in situ hybridization amplification. Pooled hazard ratios (HRs) for survival endpoints in the metastatic [progression-free survival (PFS), overall survival (OS)] and in the early [disease free-survival (DFS) and OS] settings as well as their 95% confidence intervals (95%CI) were calculated using the random-effect model of Der Simonian and Laird. The above-mentioned endpoints were also assessed according to estrogen receptor (ER) status. Results: Among 1,916 identified records, 42 studies including 1,797,377 patients were eligible for this analysis. We show the pooled HRs in the overall population and specific subgroups. In the early setting, HER2-Low status was associated with significant improved DFS (HR 0.86, 95%CI 0.79-0.92, p<0.001) and OS (HR 0.84, 95%CI 0.77-0.92, p<0.001) when compared to HER2-zero status. Improved OS was observed in subgroup analysis for both ER-positive and ER-negative HER2-Low populations, while DFS improvement was observed only in the ER-positive subgroup. Similarly, in the metastatic setting, patients affected by HER2-Low BC showed better OS when compared to those with HER2-zero BC (HR 0.94, 95%CI 0.89-0.98, p=0.008). HER2-Low metastatic BC was associated with significant improvement in OS compared to HER2-zero BC also in ER-positive and ER-negative subgroups. No significant differences were found in terms of PFS. Conclusions: Compared with HER2-zero status, HER2-Low status appears to be associated with an increased OS both in the advanced and early settings, regardless of hormone-receptor expression. [Table: see text]

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Prognostic implications of HER2Neu-low in metastatic breast cancer.

Cited by 4 publications

References 0 publications

The association between HER2-low expression and prognosis of breast cancer: a systematic review and meta-analysis

The association between HER2-low expression and prognosis of breast cancer: a systematic review and meta-analysis

The association between HER2-low status and survival in patients with metastatic breast cancer treated with Cyclin-dependent kinases 4 and 6 inhibitors: a systematic review and meta-analysis

Prognostic value of HER2-low status in breast cancer: A systematic review and meta-analysis.

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