早期乳腺癌的Oncotype Dx评分、HER2低表达与临床结局：一项国家癌症数据库分析

Oncotype Dx Score, HER2 Low Expression, and Clinical Outcomes in Early-Stage Breast Cancer: A National Cancer Database Analysis.

作者信息

Roy Arya Mariam, Jiang Changchuan, Perimbeti Stuthi, Deng Lei, Shapiro Charles L, Gandhi Shipra

机构信息

Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.

Division of Hematology and Medical Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

出版信息

Cancers (Basel). 2023 Aug 25;15(17):4264. doi: 10.3390/cancers15174264.

BACKGROUND

The interaction between HER2-low expression, oncotype recurrence score (RS), and their influence on the prognosis of HR+/HER2- breast cancer (BC) is not very well studied.

METHODS

We conducted a retrospective cohort study of patients diagnosed with resectable HER2-low and HER2-zero BC from the National Cancer Database. The primary outcome was overall survival (OS), and the association of RS with the clinical outcomes in HR+/HER2- BC was analyzed as an exploratory endpoint.

RESULTS

The distribution of RS was comparable between HER2-low and HER2-zero groups; however, the RSs of HER2-low tumors were more likely to be 16-25. Women with HER2-low tumors had longer 5-year OS than women with HER2-zero tumors in the HR-negative (84.3% vs. 83.9%; < 0.001, HR: 0.87 (0.84-0.90), < 0.001) but not in the HR-positive group (94.0% vs. 94.0%; = 0.38, HR: 0.97 (0.95-0.99), = 0.01). The survival advantage was observed in patients who received adjuvant/neoadjuvant chemotherapy (p-interaction (chemo vs. no chemo) < 0.001). Among those who received adjuvant chemotherapy in the group with higher RSs (26-100), those with HER2-low BC had higher 5-year OS than HER2-zero BC.

CONCLUSIONS

Resectable HER2-low BC had a better prognosis than HER2-zero BC. Among those who received adjuvant chemotherapy in the higher oncotype RS group, those with HER2-low tumors had better survival.

背景

人表皮生长因子受体2（HER2）低表达、肿瘤复发评分（RS）之间的相互作用及其对激素受体阳性/人表皮生长因子受体2阴性（HR+/HER2-）乳腺癌（BC）预后的影响尚未得到充分研究。

方法

我们对国家癌症数据库中诊断为可切除的HER2低表达和HER2零表达乳腺癌患者进行了一项回顾性队列研究。主要结局为总生存期（OS），并将RS与HR+/HER2-乳腺癌临床结局的关联作为探索性终点进行分析。

结果

HER2低表达组和HER2零表达组的RS分布具有可比性；然而，HER2低表达肿瘤的RS更可能为16 - 25。在HR阴性患者中，HER2低表达肿瘤的女性5年总生存期长于HER2零表达肿瘤的女性（84.3%对83.9%；P<0.001，风险比[HR]：0.87[0.84 - 0.90]，P<0.001），但在HR阳性组中并非如此（94.0%对94.0%；P = 0.38，HR：0.97[0.95 - 0.99]，P = 0.01）。在接受辅助/新辅助化疗的患者中观察到生存优势（化疗与未化疗的P交互作用<0.001）。在RS较高（26 - 100）的组中接受辅助化疗的患者中，HER2低表达乳腺癌患者的5年总生存期高于HER2零表达乳腺癌患者。