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Abstract：
BACKGROUND: Breast cancers without HER2 amplification but still expressing this membrane protein constitute a new entity called HER2-low tumors. It is important to characterize them in terms of sensitivity to treatment and prognosis.
METHODS: To investigate chemosensitivity and long-term prognosis of HER2-low early breast cancer (eBC), compared to HER2-0 tumors, we retrospectively retrieved clinicopathological characteristics, response to treatment, and survival data from 511 patients treated for eBC with neoadjuvant chemotherapy (NAC) in a French cancer center between 2007 and 2018. Factors associated with the achievement of pathologic complete response (pCR) and survival were studied among hormone receptor positive (HR+) and negative (HR-) eBC.
RESULTS: A total of 280 HR+ (61% HER2-low), and 231 HR- (28% HER2-low) eBC were included. We found classical clinicopathological factors usually associated with chemosensitivity and prognosis, in both HR+ and HR- eBC. By uni- and multivariable analysis, HER2 status (low vs 0) was not independently associated with pCR, either in HR+ or HR- eBC. Relapse free (RFS) and overall survival (OS) were not significantly different between HER2-low and HER2-0 among HR+ tumors. In contrast, among HR- negative tumors, RFS and OS were slightly better in HER2-0 eBC by univariable but not by multivariable analysis.
CONCLUSIONS: In eBC patients treated with NAC, taking into account HR expression subtype and other current clinicopathological features, HER2-low tumors did not appear to have different chemosensitivity or prognosis, compared to their HER2-0 counterparts.
METHODS: To investigate chemosensitivity and long-term prognosis of HER2-low early breast cancer (eBC), compared to HER2-0 tumors, we retrospectively retrieved clinicopathological characteristics, response to treatment, and survival data from 511 patients treated for eBC with neoadjuvant chemotherapy (NAC) in a French cancer center between 2007 and 2018. Factors associated with the achievement of pathologic complete response (pCR) and survival were studied among hormone receptor positive (HR+) and negative (HR-) eBC.
RESULTS: A total of 280 HR+ (61% HER2-low), and 231 HR- (28% HER2-low) eBC were included. We found classical clinicopathological factors usually associated with chemosensitivity and prognosis, in both HR+ and HR- eBC. By uni- and multivariable analysis, HER2 status (low vs 0) was not independently associated with pCR, either in HR+ or HR- eBC. Relapse free (RFS) and overall survival (OS) were not significantly different between HER2-low and HER2-0 among HR+ tumors. In contrast, among HR- negative tumors, RFS and OS were slightly better in HER2-0 eBC by univariable but not by multivariable analysis.
CONCLUSIONS: In eBC patients treated with NAC, taking into account HR expression subtype and other current clinicopathological features, HER2-low tumors did not appear to have different chemosensitivity or prognosis, compared to their HER2-0 counterparts.
摘要：
背景：没有HER2扩增但仍然表达这种膜蛋白的乳腺癌构成了一种新的实体，称为低HER2肿瘤。在对治疗和预后的敏感性方面表征它们是重要的。
方法：为了研究低HER2早期乳腺癌（eBC）的化疗敏感性和长期预后，与HER2-0肿瘤相比，我们回顾性检索临床病理特征，对治疗的反应，以及2007年至2018年间在法国癌症中心接受新辅助化疗（NAC）治疗的511例患者的生存数据。在激素受体阳性（HR）和阴性（HR-）eBC中研究了与实现病理完全缓解（pCR）和生存相关的因素。
结果：总共280HR+（61%HER2低），和231个HR-（28％HER2低）eBC被包括在内。我们发现经典的临床病理因素通常与化疗敏感性和预后相关，在HR+和HR-eBC中。通过单变量和多变量分析，HER2状态（低vs0）与pCR无关，在HR+或HR-EBC中。在HR+肿瘤中，低HER2和HER2-0之间的无复发（RFS）和总生存期（OS）没有显着差异。相比之下,在HR阴性肿瘤中，通过单变量分析，RFS和OS在HER2-0eBC中略好，而不是通过多变量分析。
结论：在接受NAC治疗的eBC患者中，考虑到HR表达亚型和其他当前临床病理特征，低HER2肿瘤似乎没有不同的化疗敏感性或预后，与他们的HER2-0同行相比。
方法：为了研究低HER2早期乳腺癌（eBC）的化疗敏感性和长期预后，与HER2-0肿瘤相比，我们回顾性检索临床病理特征，对治疗的反应，以及2007年至2018年间在法国癌症中心接受新辅助化疗（NAC）治疗的511例患者的生存数据。在激素受体阳性（HR）和阴性（HR-）eBC中研究了与实现病理完全缓解（pCR）和生存相关的因素。
结果：总共280HR+（61%HER2低），和231个HR-（28％HER2低）eBC被包括在内。我们发现经典的临床病理因素通常与化疗敏感性和预后相关，在HR+和HR-eBC中。通过单变量和多变量分析，HER2状态（低vs0）与pCR无关，在HR+或HR-EBC中。在HR+肿瘤中，低HER2和HER2-0之间的无复发（RFS）和总生存期（OS）没有显着差异。相比之下,在HR阴性肿瘤中，通过单变量分析，RFS和OS在HER2-0eBC中略好，而不是通过多变量分析。
结论：在接受NAC治疗的eBC患者中，考虑到HR表达亚型和其他当前临床病理特征，低HER2肿瘤似乎没有不同的化疗敏感性或预后，与他们的HER2-0同行相比。
