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Fcγ 受体多态性与曲妥珠单抗治疗的 HER2+ 乳腺癌患者结局的相关性研究,该研究来自 NCCTG(Alliance)试验 N9831。

Association studies of Fcγ receptor polymorphisms with outcome in HER2+ breast cancer patients treated with trastuzumab in NCCTG (Alliance) Trial N9831.

机构信息

Mayo Clinic, Jacksonville, Florida.

Stanford University, Stanford, California.

出版信息

Cancer Immunol Res. 2014 Oct;2(10):962-9. doi: 10.1158/2326-6066.CIR-14-0059. Epub 2014 Jul 2.


DOI:10.1158/2326-6066.CIR-14-0059
PMID:24989892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4215796/
Abstract

Patients with HER2+ breast cancer treated with trastuzumab and chemotherapy have superior survival compared with patients treated with chemotherapy alone. Polymorphisms within FCGR2A and FCGR3A are associated with binding affinity of natural killer cells to the IgG1 portion of trastuzumab, and a polymorphism in FCGR2B (I232T) is associated with impaired regulatory activity. The association of these polymorphisms with clinical response among trastuzumab-treated patients is equivocal, with both positive and negative associations. We performed genotyping analysis on the FCGR3A V158F, FCGR2A R131H, and FCGR2B I232T polymorphisms in 1,325 patients from the N9831 clinical trial. Patients in arm A (N = 419) received chemotherapy only. Patients in arms B (N = 469) and C (N = 437) were treated with chemotherapy and trastuzumab (sequentially in arm B and concurrently in arm C). Using log-rank test and Cox proportional hazard models, we compared disease-free survival (DFS) among genotypic groups within pooled arms B/C. We found no differences in DFS between trastuzumab-treated patients who had the FCGR3A 158 V/V and/or FCGR2A 131 H/H high-affinity genotypes and patients without those genotypes. Furthermore, there was no significant interaction between FCGR3A and FCGR2A and treatment. However, there was a difference in DFS for FCGR2B I232T, with I/I patients deriving benefit from trastuzumab (P < 0.001), compared with the T carriers who did not (P = 0.81). The interaction between FCGR2B genotype and treatment was statistically significant (P = 0.03). Our analysis did not reveal an association between FcγR high-affinity genotypes and outcomes. However, it seems that the FCGR2B inhibitory gene may be predictive of adjuvant trastuzumab benefit.

摘要

接受曲妥珠单抗和化疗治疗的 HER2+乳腺癌患者的生存情况优于单独接受化疗的患者。FCGR2A 和 FCGR3A 内的多态性与自然杀伤细胞与曲妥珠单抗 IgG1 部分的结合亲和力有关,而 FCGR2B 中的一个多态性(I232T)与调节活性受损有关。这些多态性与曲妥珠单抗治疗患者的临床反应之间的关联尚无定论,既有正相关也有负相关。我们在 N9831 临床试验中的 1325 名患者中对 FCGR3A V158F、FCGR2A R131H 和 FCGR2B I232T 多态性进行了基因分型分析。A 臂(N = 419)的患者仅接受化疗。B 臂(N = 469)和 C 臂(N = 437)的患者接受化疗和曲妥珠单抗治疗(B 臂序贯治疗,C 臂同时治疗)。使用对数秩检验和 Cox 比例风险模型,我们比较了 pooled 臂 B/C 中不同基因型组之间的无病生存期(DFS)。我们发现,在具有 FCGR3A 158 V/V 和/或 FCGR2A 131 H/H 高亲和力基因型的曲妥珠单抗治疗患者与没有这些基因型的患者之间,DFS 没有差异。此外,FCGR3A 和 FCGR2A 与治疗之间没有显著的相互作用。然而,FCGR2B I232T 的 DFS 存在差异,I/I 患者从曲妥珠单抗治疗中获益(P < 0.001),而 T 携带者则没有(P = 0.81)。FCGR2B 基因型与治疗之间的相互作用具有统计学意义(P = 0.03)。我们的分析没有发现 FcγR 高亲和力基因型与结局之间的关联。然而,似乎 FCGR2B 抑制基因可能是预测曲妥珠单抗辅助治疗获益的标志物。

相似文献

[1]
Association studies of Fcγ receptor polymorphisms with outcome in HER2+ breast cancer patients treated with trastuzumab in NCCTG (Alliance) Trial N9831.

Cancer Immunol Res. 2014-7-2

[2]
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[3]
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[4]
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[5]
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[6]
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引用本文的文献

[1]
FCGR3A V158F gene polymorphism and trastuzumab response in HER2-positive breast cancer patients.

Sci Rep. 2024-10-29

[2]
Serum immunoglobulin and the threshold of Fc receptor-mediated immune activation.

Biochim Biophys Acta Gen Subj. 2023-11

[3]
Update Breast Cancer 2022 Part 5 - Early Stage Breast Cancer.

Geburtshilfe Frauenheilkd. 2023-3-9

[4]
Association between genome-wide epigenetic and genetic alterations in breast cancer tissue and response to HER2-targeted therapies in HER2-positive breast cancer patients: new findings and a systematic review.

Cancer Drug Resist. 2022-11-2

[5]
Margetuximab Versus Trastuzumab in Patients With Previously Treated HER2-Positive Advanced Breast Cancer (SOPHIA): Final Overall Survival Results From a Randomized Phase 3 Trial.

J Clin Oncol. 2023-1-10

[6]
Resistance to Trastuzumab.

Cancers (Basel). 2022-10-19

[7]
Relevance of Fc Gamma Receptor Polymorphisms in Cancer Therapy With Monoclonal Antibodies.

Front Oncol. 2022-6-24

[8]
Role of Fcγ receptors in HER2-targeted breast cancer therapy.

J Immunother Cancer. 2022-1

[9]
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Breast. 2021-12

[10]
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本文引用的文献

[1]
Phase II randomized study of trastuzumab emtansine versus trastuzumab plus docetaxel in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer.

J Clin Oncol. 2013-2-4

[2]
ABCB1, FCGR2A, and FCGR3A polymorphisms in patients with HER2-positive metastatic breast cancer who were treated with first-line taxane plus trastuzumab chemotherapy.

Oncology. 2012-8-16

[3]
Analysis of Fcγ receptor IIIa and IIa polymorphisms: lack of correlation with outcome in trastuzumab-treated breast cancer patients.

Clin Cancer Res. 2012-4-13

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Adjuvant trastuzumab in HER2-positive breast cancer.

N Engl J Med. 2011-10-6

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Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human epidermal growth factor receptor 2-positive breast cancer: joint analysis of data from NCCTG N9831 and NSABP B-31.

J Clin Oncol. 2011-7-18

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FcγR2A and 3A polymorphisms predict clinical outcome of trastuzumab in both neoadjuvant and metastatic settings in patients with HER2-positive breast cancer.

Ann Oncol. 2010-11-25

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Hum Mol Genet. 2010-5-27

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Immunol Cell Biol. 2008

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HER2-positive breast cancer: from trastuzumab to innovatory anti-HER2 strategies.

Clin Breast Cancer. 2008-2

[10]
Correlation between NK function and response to trastuzumab in metastatic breast cancer patients.

J Transl Med. 2008-5-16

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