de Castro Douglas Guedes, Pellizzon Antônio Cássio Assis, Braun Alexcia Camila, Chen Michael Jenwei, Silva Maria Letícia Gobo, Fogaroli Ricardo Cesar, Gondim Guilherme Rocha Melo, Ramos Henderson, Neto Elson Santos, Abrahão Carolina Humeres, Yu Liao Shin, Abdallah Emne Ali, Calsavara Vinicius Fernando, Chinen Ludmilla Thomé Domingos
Department of Radiation Oncology, A.C.Camargo Cancer Center, São Paulo 01509-010, Brazil.
International Research Center, A.C.Camargo Cancer Center, São Paulo 01509-010, Brazil.
Cancers (Basel). 2022 Jun 24;14(13):3101. doi: 10.3390/cancers14133101.
HER2 expression switching in circulating tumor cells (CTC) in breast cancer is dynamic and may have prognostic and predictive clinical implications. In this study, we evaluated the association between the expression of HER2 in the CTC of patients with breast cancer brain metastases (BCBM) and brain disease control. An exploratory analysis of a prospective assessment of CTC before (CTC1) and after (CTC2) stereotactic radiotherapy/radiosurgery (SRT) for BCBM in 39 women was performed. Distant brain failure-free survival (DBFFS), the primary endpoint, and overall survival (OS) were estimated. After a median follow-up of 16.6 months, there were 15 patients with distant brain failure and 16 deaths. The median DBFFS and OS were 15.3 and 19.5 months, respectively. The median DBFFS was 10 months in patients without HER2 expressed in CTC and was not reached in patients with HER2 in CTC ( = 0.012). The median OS was 17 months in patients without HER2 in CTC and was not reached in patients with HER2 in CTC ( = 0.104). On the multivariate analysis, DBFFS was superior in patients who were primary immunophenotype (PIP) HER2-positive (HR 0.128, 95% CI 0.025-0.534; = 0.013). The expression of HER2 in CTC was associated with a longer DBFFS, and the switching of HER2 expression between the PIP and CTC may have an impact on prognosis and treatment selection for BCBM.
乳腺癌循环肿瘤细胞（CTC）中的HER2表达转换是动态的，可能具有预后和预测的临床意义。在本研究中，我们评估了乳腺癌脑转移（BCBM）患者CTC中HER2表达与脑部疾病控制之间的关联。对39名女性BCBM患者在立体定向放疗/放射外科手术（SRT）前（CTC1）和后（CTC2）的CTC进行前瞻性评估，并进行探索性分析。估计了远处无脑衰竭生存期（DBFFS）这一主要终点以及总生存期（OS）。中位随访16.6个月后，有15例患者出现远处脑衰竭，16例死亡。中位DBFFS和OS分别为15.3个月和19.5个月。CTC中未表达HER2的患者中位DBFFS为10个月，而CTC中表达HER2的患者未达到该值（P = 0.012）。CTC中未表达HER2的患者中位OS为17个月，而CTC中表达HER2的患者未达到该值（P = 0.104）。多因素分析显示，原发性免疫表型（PIP）HER2阳性的患者DBFFS更长（HR 0.128，95%CI 0.025 - 0.534；P = 0.013）。CTC中HER2的表达与更长的DBFFS相关，PIP和CTC之间HER2表达的转换可能对BCBM的预后和治疗选择产生影响。
