Division of Hematology-Oncology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Division of Radiation Oncology, Oncology Center, King Saud University, Riyadh, Saudi Arabia.
PLoS One. 2021 Mar 5;16(3):e0247802. doi: 10.1371/journal.pone.0247802. eCollection 2021.
The prognostic impact of neoadjuvant chemotherapy (NAC) on the receptor expression status in patients with locally advanced breast cancer (LABC) is still not fully understood. We aimed to evaluate the changes in hormone (estrogen and progesterone) receptor (HR) and human epidermal growth factor receptor 2 (HER2) status post-NAC and their correlation with survival.
Patients with LABC who have received NAC between 2008 and 2015 and have been followed up till December 2019 at the Oncology Center, King Saud University, KSA were analyzed retrospectively. biomarker analysis of ER, PR & HER2 were done using immunohistochemistry (IHC) and Fluorescent in situ hybridization.
Ninety-one patients fulfilled the inclusion criteria. HR status changed in 21(23.1%) patients, with a significant difference between patients with stable receptors and those with any receptor conversion; p = 0.000. Five (5.5%) initially HER2 negative tumors became HER2 positive and 10 (11%) initially HER2 positive tumors became HER2 negative after NAC. The difference in HER2 expression level before and after NAC was not statistically significant (p = 0.302). Univariate analysis relating patients' characteristics and 10-years disease-free survival (DFS) showed only significant correlations with the expressions of ER, PR, and any receptor conversion, (ER and/or PR) p< 0.001, p< 0.001, and p = 0.001; respectively. In the univariate analysis, none of the clinicopathological features showed a significant correlation with the OS except for the molecular subtypes P<0.001.
Patients with LABC have significant changes in the ER and PR receptor status following NAC. Post-NAC expressions change of ER and PR (ER and/or PR) are correlated to DFS. Retesting of the hormone receptors should be considered after NAC in Saudi patients with LABC.
新辅助化疗（NAC）对局部晚期乳腺癌（LABC）患者受体表达状态的预后影响尚不完全清楚。我们旨在评估 NAC 后激素（雌激素和孕激素）受体（HR）和人表皮生长因子受体 2（HER2）状态的变化及其与生存的相关性。
回顾性分析了 2008 年至 2015 年期间在沙特阿拉伯国王大学肿瘤中心接受 NAC 治疗并随访至 2019 年 12 月的 LABC 患者。使用免疫组织化学（IHC）和荧光原位杂交法对 ER、PR 和 HER2 进行生物标志物分析。
91 例患者符合纳入标准。21 例（23.1%）患者的 HR 状态发生变化，稳定受体患者与任何受体转换患者之间存在显著差异；p = 0.000。5 例（5.5%）初始 HER2 阴性肿瘤变为 HER2 阳性，10 例（11%）初始 HER2 阳性肿瘤变为 HER2 阴性。NAC 前后 HER2 表达水平无统计学差异（p = 0.302）。单因素分析显示，患者特征与 10 年无病生存率（DFS）的关系仅与 ER、PR 和任何受体转换（ER 和/或 PR）的表达相关，p<0.001、p<0.001 和 p = 0.001；分别。在单因素分析中，除了分子亚型外，p<0.001，没有任何临床病理特征与 OS 有显著相关性。
LABC 患者在 NAC 后 ER 和 PR 受体状态发生显著变化。NAC 后 ER 和 PR（ER 和/或 PR）表达的变化与 DFS 相关。在沙特阿拉伯的 LABC 患者中，NAC 后应考虑重新检测激素受体。
