Pathological complete response rate and clinical outcome after neoadjuvant therapy of HER2-low breast cancer: A National Cancer Database Analysis

医学 乳腺癌 内科学 肿瘤科 癌症 新辅助治疗 比例危险模型 病态的 阶段(地层学) 队列 古生物学 生物
作者
Guansheng Zhong,Dajiang Song,Weiyang Lou,Bajin Wei,Yaomin Chen,Hongwu Cui,Jingjing Hu,Huaying Dong,Jie Chen,Zhijun Dai
出处
期刊:Ejso [Elsevier BV]
卷期号:49 (11): 106970-106970 被引量:4
标识
DOI:10.1016/j.ejso.2023.06.022
摘要

Abstract

Background

The interest in breast cancer with low HER2 expression as a distinct subtype is increasing. We aimed to explore the differences between HER2-low and HER2-zero breast cancer in their prognosis and rate of pathological complete response (pCR) after neoadjuvant therapy.

Methods

The National Cancer Database (NCDB) was used to select patients with breast cancer who received neoadjuvant therapy from 2004 to 2017. Logistic regression model was constructed for analysis of pCR. Cox proportional hazards regression model and Kaplan–Meier method were used for survival analysis.

Results

A total of 41500 breast cancer patients were included, among which 14814 (35.7%) had HER2-zero tumors and 26686 (64.3%) had HER2-low. HER2-low tumors were more commonly HR-positive in comparison with HER2-zero (66.3% versus 47.1%, P < 0.001). A lower rate of pCR was observed in HER2-low tumors than in HER2-zero tumors after neoadjuvant therapy in the total cohort (OR = 0.90; 95% CI [0.86–0.95]; P < 0.001) and in the subset of HR-positive (OR = 0.87; 95% CI [0.81–0.94]; P < 0.001). Patients with HER2-low tumors had a significantly superior survival than those with HER2-zero tumors (HR = 0.90; 95% CI [0.86–0.94]; P < 0.001), regardless of the HR status. Additionally, a marginal survival difference was also observed between HER2 IHC1+ and HER2 IHC2+/ISH-negative (HR = 0.91; 95% CI [0.85–0.97]; P = 0.003) cohorts.

Conclusion

HER2-low tumors are a clinically relevant breast cancer subtype that is distinct from HER2-zero tumors. These findings may provide clues to appropriate therapeutic strategies for this subtype in the future.
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