Purpose. The prognostic and predictive role of trophoblast cell-surface antigen-2 (Trop-2) overexpression in human epidermal growth factor receptor 2-positive (HER2-positive) breast cancer is yet unknown. We retrospectively analyzed Trop-2 expression and its correlation with clinicopathologic features and pathological complete response (pCR) in HER2-positive early breast cancer (EBC) patients treated with neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) in the PHERGain study.Methods. Trop-2 expression at baseline was determined in formalin-xed, para n-embedded primary tumor biopsies by immunohistochemistry and was rst classi ed into expressing (Trop-2-positive) or notexpressing (Trop-2-negative) tumors. Then, it was classi ed by histochemical score (H-score) according to its intensity into low (0-9), intermediate (10-49), and high (≥50). The association between clinicopathologic features, pCR, and Trop-2 expression was performed with Fisher's exact test.Results. Forty-one patients with tissue evaluable for Trop-2 expression were included, with 28 (68.3%) Trop-2-positive tumors. Overall, 17 (41.46%), 14 (34.15%), and 10 (24.40%) tumors were classi ed as low, intermediate, and high, respectively. Trop-2 expression was signi cantly associated with decreased pCR rates (50.0% vs. 92.3%; odds ratio [OR] 0.05; 95% CI, 0.002-0.360]; p adjusted=0.01) but was not correlated with any clinicopathologic features (p≥0.05). Tumors with the highest Trop-2 H-score were less likely to obtain a pCR (OR 0.03; 95% CI, 0.001-0.290, p adjusted<0.01). This association was con rmed in univariate and multivariate regression analyses.
Conclusion. These ndings suggest a potential role of Trop-2 expression as a biomarker of resistance to neoadjuvant chemotherapy plus dual HER2 blockade and may become a strategic target for future combinations in HER2-positive EBC patients.