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.
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。