Risk of Recurrence in Patients With HER2+ Early-Stage Breast Cancer: Literature Analysis of Patient and Disease Characteristics

O’Shaughnessy, Joyce; Gradishar, William J.; O’Regan, Ruth; Gadi, Vijayakrishna K.

doi:10.1016/j.clbc.2023.03.007

Cited by 13 publications

(8 citation statements)

References 90 publications

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“…Additionally, there seemed to be associated with menstrual status and BMI to induce breast cancer with different subtypes [22]. An increased BMI was one of the confounding factors to lead HER2-positive early breast cancer recurrence [23]. There was a review of modifiable risk factors inducing more breast cancers, which pointed out BMI might be one of the probable inducing factors, though lots of patients should be needed to obtain the statistical power [24].…”

Section: Discussionmentioning

confidence: 99%

Interferon-Gamma Secretion Is Significantly Decreased in Stage III Breast Cancer Patients

Yi,

Schneider,

Lim

et al. 2024

IJMS

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Even though some studies have shown possible clinical relationship between molecular subtypes and tumor infiltrating natural killer (NK) cells around tumors, there are few studies showing the clinical relevance of peripheral NK cell activity at diagnosis in female patients with invasive breast cancer. A total of 396 female invasive breast cancer patients who received curative surgical treatment from March 2017 to July 2021 were retrospectively analyzed. NK cell activation-induced interferon-gamma (IFN-γ) secretion measured by enzyme-linked immunosorbent assay was used to measure the activity of peripheral NK cells. Statistical analyses were performed to determine clinical relationships with major clinicopathologic parameters. Quadripartite NK cell activity measured by induced interferon-gamma showed significant relevance with staging and body mass index, and some of the inflammatory serological markers, namely N/L (neutrophil/lymphocyte), P/N (platelet/neutrophil), and P/L (platelet/lymphocyte), showed significantly different NK activity in each interval by univariate analysis. A binary subgroup analysis, setting the IFN-γ secretion cut-off at 100 pg/mL, showed that stage III was significantly increased and axillary lymph node metastasis positivity was increased in the group of IFN-γ < 100 pg/mL, and IFN-γ secretion decreased with an increasing N stage, increased BMI (body mass index), and decreased production of IFN-γ. Following this, the same binary analysis, but with the IFN-γ secretion cut-off at 250 pg/mL, also showed that secretion in stage III was increased in those concentrations with <250 pg/mL, axillary lymph node positivity appeared to be correlated, and BMI ≥ 30 increased in prevalence. Additional ANOVA post hoc tests (Bonferroni) were performed on some serological markers that tended to be somewhat inconsistent. By subgroup analysis with Bonferroni adjustment between the IFN-γ secretion and TNM stage, no significant difference in IFN-γ secretion could be identified at stages I, II, and IV, but at stage III, the IFN-γ secretion < 100 pg/mL was significantly higher than 250 ≤ IFN-γ secretion < 500 pg/mL or IFN-γ secretion ≥ 500 pg/mL. According to this study, stage III was significantly associated with the lowest IFN-γ secretion. Compared to a higher level of IFN-γ secretion, a lower level of IFN-γ secretion seemed to be associated with increased body mass index. Unlike when IFN-γ secretion was analyzed in quartiles, as the IFN-γ secretion fell below 100 pg/mL, the correlation between axillary lymph node positivity and increased N stage, increased BMI, and increased N/L and P/L, which are suggested poor prognostic factors, became more pronounced. We think a peripheral IFN-γ secretion test might be convenient and useful tool for pretreatment risk assessment and selecting probable candidates for further treatment such as immunotherapy in some curable but high-risk invasive breast cancer patients, compared to other costly assaying of tissue NK cell activity at diagnosis.

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Section: Discussionmentioning

confidence: 99%

Interferon-Gamma Secretion Is Significantly Decreased in Stage III Breast Cancer Patients

Yi,

Schneider,

Lim

et al. 2024

IJMS

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“…HR status remained an important risk factor for recurrence, with HR-positive/HER2-positive disease more likely to recur. Nevertheless, the association between HR status and HER2-positive BC recurrence is highly context dependent (e.g., adjuvant/neoadjuvant treatment and use of endocrine therapy combined with other treatment) [14].…”

Section: Biology and Prognosis Of Hormone Receptor-positive/her2-posi...mentioning

confidence: 99%

Hormone Receptor-Positive/HER2-Positive Breast Cancer: Hormone Therapy and Anti-HER2 Treatment: An Update on Treatment Strategies

Tommasi,

Airò,

Pratticò

et al. 2024

JCM

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Hormone receptor (HR)-positive/HER2-positive breast cancer represents a distinct subtype expressing estrogen and progesterone receptors with an overexpression of HER2. Approximately 14% of female breast cancer cases are HER2-positive, with the majority being HR-positive. These tumors show a cross-talk between the hormonal and HER2 pathways; the interaction has implications for the treatment options for the disease. In this review, we analyze the biology of HR-positive/HER2-positive breast cancer and summarize the evidence concerning the standard of care options both in neoadjuvant/adjuvant settings and in advanced disease. Additionally, we focus on new trials and drugs for HR-positive/HER2-positive breast cancer and the new entity: HER2-low breast cancer.

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“…While achieving pCR is the most valuable predictive factor associated with better recurrence-related results, pathologic residual disease (pRD) indicates a higher risk for the poorest survival and for disease relapse [45]. At baseline, HER2+ BC patients with tumors > 20 mm and with the detection of LN+ prior to surgery, or postoperatively (following NAC with trastuzumab), and with residual tumors > 10 mm or LN+ are highly associated with early relapse events [45][46][47]. When there is pRD in the breast only, tumors > 10 mm have an estimated increased recurrence risk of 16% when compared to sub-centimeter tumor sizes or pCR.…”

Section: Defining Risk Categoriesmentioning

confidence: 99%

Appraisal of Systemic Treatment Strategies in Early HER2-Positive Breast Cancer—A Literature Review

Giffoni de Mello Morais Mata,

Chehade,

Hannouf

et al. 2023

Cancers

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Background: The overexpression of the human epidermal growth factor receptor 2 (HER2+) accounts for 15–20% of all breast cancer phenotypes. Even after the completion of the standard combination of chemotherapy and trastuzumab, relapse events occur in approximately 15% of cases. The neoadjuvant approach has multiple benefits that include the potential to downgrade staging and convert previously unresectable tumors to operable tumors. In addition, achieving a pathologic complete response (pCR) following preoperative systemic treatment is prognostic of enhanced survival outcomes. Thus, optimal evaluation among the suitable strategies is crucial in deciding which patients should be selected for the neoadjuvant approach. Methods: A literature search was conducted in the Embase, Medline, and Cochrane electronic libraries. Conclusion: The evaluation of tumor and LN staging and, hence, stratifying BC recurrence risk are decisive factors in guiding clinicians to optimize treatment decisions between the neoadjuvant versus adjuvant approaches. For each individual case, it is important to consider the most likely postsurgical outcome, since, if the patient does not obtain pCR following neoadjuvant treatment, they are eligible for adjuvant T-DM1 in the case of residual disease. This review of HER2-positive female BC outlines suitable neoadjuvant and adjuvant systemic treatment strategies for guiding clinical decision making around the selection of an appropriate therapy.

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Risk of Recurrence in Patients With HER2+ Early-Stage Breast Cancer: Literature Analysis of Patient and Disease Characteristics

Cited by 13 publications

References 90 publications

Interferon-Gamma Secretion Is Significantly Decreased in Stage III Breast Cancer Patients

Interferon-Gamma Secretion Is Significantly Decreased in Stage III Breast Cancer Patients

Hormone Receptor-Positive/HER2-Positive Breast Cancer: Hormone Therapy and Anti-HER2 Treatment: An Update on Treatment Strategies

Appraisal of Systemic Treatment Strategies in Early HER2-Positive Breast Cancer—A Literature Review

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