Schettini Francesco, Chic Nuria, Brasó-Maristany Fara, Paré Laia, Pascual Tomás, Conte Benedetta, Martínez-Sáez Olga, Adamo Barbara, Vidal Maria, Barnadas Esther, Fernández-Martinez Aranzazu, González-Farre Blanca, Sanfeliu Esther, Cejalvo Juan Miguel, Perrone Giuseppe, Sabarese Giovanna, Zalfa Francesca, Peg Vicente, Fasani Roberta, Villagrasa Patricia, Gavilá Joaquín, Barrios Carlos H, Lluch Ana, Martín Miguel, Locci Mariavittoria, De Placido Sabino, Prat Aleix
Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.
NPJ Breast Cancer. 2021 Jan 4;7(1):1. doi: 10.1038/s41523-020-00208-2.
Novel antibody-drug conjugates against HER2 are showing high activity in HER2-negative breast cancer (BC) with low HER2 expression (i.e., 1+ or 2+ and lack of ERBB2 amplification). However, the clinical and molecular features of HER2-low BC are yet to be elucidated. Here, we collected retrospective clinicopathological and PAM50 data from 3,689 patients with HER2-negative disease and made the following observations. First, the proportion of HER2-low was higher in HR-positive disease (65.4%) than triple-negative BC (TNBC, 36.6%). Second, within HR-positive disease, ERBB2 and luminal-related genes were more expressed in HER2-low than HER2 0. In contrast, no gene was found differentially expressed in TNBC according to HER2 expression. Third, within HER2-low, ERBB2 levels were higher in HR-positive disease than TNBC. Fourth, HER2-low was not associated with overall survival in HR-positive disease and TNBC. Finally, the reproducibility of HER2-low among pathologists was suboptimal. This study emphasizes the large biological heterogeneity of HER2-low BC, and the need to implement reproducible and sensitive assays to measure low HER2 expression.
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