Pöschke Patrik, Fasching Peter A, Adler Werner, Rübner Matthias, Beckmann Matthias W, Hack Carolin C, Heindl Felix, Hartmann Arndt, Erber Ramona, Gass Paul
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Cancers (Basel). 2023 Sep 22;15(19):4678. doi: 10.3390/cancers15194678.
In our study, we observed the long-term survival outcomes investigated for HER2-0 and HER2-low-positive breast cancer patients who received neoadjuvant chemotherapy. Between 1998 and 2020, 10,333 patients with primary breast cancer were treated, including 1373 patients with HER2-0 or HER2-low-positive disease with neoadjuvant chemotherapy. Descriptive analyses were performed, and logistic regression models and survival analyses were calculated for disease-free survival (DFS) and overall survival (OS). Among the 1373 patients, 930 (67.73%) had HER2-low-positive and 443 (32.27%) had HER2-0 tumors. Patients with HER2-0 tumors had a significantly better pathological complete response, 29.25% vs. 20.09%, and pathological complete response/in situ, 31.97% vs. 24.08%, than patients with HER2-low-positive tumors ( < 0.001; = 0.003), regardless of the hormone receptor (HR) status. No statistically significant differences were observed for the HR-positive ( = 0.315; = 0.43) or HR-negative subgroups ( = 0.573; = 0.931). DFS and OS were significantly longer for HR-positive, HER2-low-positive patients (log-rank = 0.02; = 0.012). OS was significantly longer for HR-negative, HER2-0 patients (log-rank = 0.032). No significant DFS differences were found for the HR-negative cohort (log-rank = 0.232). For the overall cohort, no significant differences were noted between HER2-low-positive and HER2-0 patients, either for DFS (log-rank = 0.220) or OS (log-rank = 0.403). These results show different survival outcomes for HER2-0 and HER2-low-positive tumors relative to HR status. These different cohorts can be identified using standardized immunohistochemistry, even retrospectively.
在我们的研究中，我们观察了接受新辅助化疗的HER2-0和HER2低表达阳性乳腺癌患者的长期生存结果。1998年至2020年期间，共治疗了10333例原发性乳腺癌患者，其中1373例HER2-0或HER2低表达阳性疾病患者接受了新辅助化疗。进行了描述性分析，并计算了无病生存期（DFS）和总生存期（OS）的逻辑回归模型和生存分析。在这1373例患者中，930例（67.73%）为HER2低表达阳性，443例（32.27%）为HER2-0肿瘤。HER2-0肿瘤患者的病理完全缓解率显著更高，分别为29.25%和20.09%，病理完全缓解/原位癌分别为31.97%和24.08%，高于HER2低表达阳性肿瘤患者（<0.001；=0.003），无论激素受体（HR）状态如何。HR阳性（=0.315；=0.43）或HR阴性亚组（=0.573；=0.931）未观察到统计学显著差异。HR阳性、HER2低表达阳性患者的DFS和OS显著更长（对数秩=0.02；=0.012）。HR阴性、HER2-0患者的OS显著更长（对数秩=0.032）。HR阴性队列未发现显著的DFS差异（对数秩=0.232）。对于整个队列，HER2低表达阳性和HER2-0患者之间在DFS（对数秩=0.220）或OS（对数秩=0.403）方面均未发现显著差异。这些结果表明，相对于HR状态，HER2-0和HER2低表达阳性肿瘤的生存结果不同。即使是回顾性地，也可以使用标准化免疫组织化学识别这些不同的队列。
