PDF(Pubmed)
Abstract：
BACKGROUND: The survival outcomes in HER2-low versus HER2-zero breast cancer (BC) after neoadjuvant chemotherapy (NACT) remain unclear. The meta-analysis was conducted to summarize current evidence about the survival outcomes in HER2-low versus HER2-zero BC.
METHODS: We conducted a systematic search in PubMed and EMBASE databases to identify relevant studies.
RESULTS: A total of 14 studies with 53,714 patients were included. Overall, 34,037 patients (63.37%) were HER2-low, and 19,677 patients (36.63%) were HER2-zero. Patients with HER2-low tumors had a significantly lower pathological complete response (pCR) rate than patients with HER2-zero tumors, regardless of the hormone receptor status. Compared with HER2-zero breast cancer, the overall survival (OS) and disease-free survival (DFS) of HER2-low BC were longer in the overall cohort (HR = 0.72; 95% CI = 0.61-0.85; P < 0.0001; HR = 0.83; 95% CI = 0.75-0.92; P = 0.0002); however, no differences were observed in terms of OS and DFS between HER2-low and HER2-zero BC in the HR-negative group. In the HR-positive group, HER2-low status had no significant impact on OS, while significantly associated with increased DFS (HR = 0.85; 95% CI = 0.76-0.96; P = 0.007).
CONCLUSIONS: These results suggest that although HER2-low BC has a poor response to NACT, it is correlated with favorable OS and DFS after NACT in the overall cohort as well as longer DFS in the HR-positive group.
METHODS: We conducted a systematic search in PubMed and EMBASE databases to identify relevant studies.
RESULTS: A total of 14 studies with 53,714 patients were included. Overall, 34,037 patients (63.37%) were HER2-low, and 19,677 patients (36.63%) were HER2-zero. Patients with HER2-low tumors had a significantly lower pathological complete response (pCR) rate than patients with HER2-zero tumors, regardless of the hormone receptor status. Compared with HER2-zero breast cancer, the overall survival (OS) and disease-free survival (DFS) of HER2-low BC were longer in the overall cohort (HR = 0.72; 95% CI = 0.61-0.85; P < 0.0001; HR = 0.83; 95% CI = 0.75-0.92; P = 0.0002); however, no differences were observed in terms of OS and DFS between HER2-low and HER2-zero BC in the HR-negative group. In the HR-positive group, HER2-low status had no significant impact on OS, while significantly associated with increased DFS (HR = 0.85; 95% CI = 0.76-0.96; P = 0.007).
CONCLUSIONS: These results suggest that although HER2-low BC has a poor response to NACT, it is correlated with favorable OS and DFS after NACT in the overall cohort as well as longer DFS in the HR-positive group.
摘要：
背景：新辅助化疗（NACT）后低HER2与零HER2乳腺癌（BC）的生存结果尚不清楚。进行荟萃分析以总结当前关于低HER2与零HER2BC生存结局的证据。
方法：我们在PubMed和EMBASE数据库中进行了系统检索，以确定相关研究。
结果：共纳入14项研究，共53,714例患者。总的来说,34,037例患者（63.37％）HER2低，19,677例患者（36.63%）为HER2-零。低HER2肿瘤患者的病理完全缓解（pCR）率明显低于零HER2肿瘤患者，不管激素受体的状态。与HER2-zero乳腺癌相比，在整个队列中,HER2低BC的总生存期(OS)和无病生存期(DFS)更长(HR=0.72;95%CI=0.61-0.85;P<0.0001;HR=0.83;95%CI=0.75-0.92;P=0.0002);在HR阴性组中,低HER2和零HER2BC的OS和DFS没有差异.在HR阳性组中，HER2低状态对OS没有显著影响，而与DFS增加显著相关(HR=0.85;95%CI=0.76-0.96;P=0.007)。
结论：这些结果表明，尽管低HER2BC对NACT的反应较差，在整个队列中,它与NACT后良好的OS和DFS相关,在HR阳性组中与较长的DFS相关.
方法：我们在PubMed和EMBASE数据库中进行了系统检索，以确定相关研究。
结果：共纳入14项研究，共53,714例患者。总的来说,34,037例患者（63.37％）HER2低，19,677例患者（36.63%）为HER2-零。低HER2肿瘤患者的病理完全缓解（pCR）率明显低于零HER2肿瘤患者，不管激素受体的状态。与HER2-zero乳腺癌相比，在整个队列中,HER2低BC的总生存期(OS)和无病生存期(DFS)更长(HR=0.72;95%CI=0.61-0.85;P<0.0001;HR=0.83;95%CI=0.75-0.92;P=0.0002);在HR阴性组中,低HER2和零HER2BC的OS和DFS没有差异.在HR阳性组中，HER2低状态对OS没有显著影响，而与DFS增加显著相关(HR=0.85;95%CI=0.76-0.96;P=0.007)。
结论：这些结果表明，尽管低HER2BC对NACT的反应较差，在整个队列中,它与NACT后良好的OS和DFS相关,在HR阳性组中与较长的DFS相关.
