Moss Nelson S, Singh Jolene M, Reiner Anne S, Drago Joshua Z, Modi Shanu, Seidman Andrew D, Chandarlapaty Sarat, Ross Dara S
Memorial Sloan Kettering Cancer Center, Department of Neurosurgery and Brain Metastasis Center, New York, NY, USA.
Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY, USA.
NPJ Breast Cancer. 2023 Oct 23;9(1):86. doi: 10.1038/s41523-023-00592-5.
The HER2-directed antibody-drug conjugate trastuzumab deruxtecan is active against lower levels of HER2 expression than prior-generation therapies. The rate of HER2 expression in brain metastases among patients with initially HER2-null breast cancer is undefined, and receptor discordance in advanced breast cancer with brain metastases may underestimate CNS response potential in the absence of brain metastasis sampling. In this cohort study including 136 patients with 401 samples scored according to ASCO/CAP guidelines, 15/28 patients (54%) with HER2-null primary breast cancer have detectable HER2 expression in subsequently resected brain metastases, a significant discordant population.
HER2导向的抗体药物偶联物曲妥珠单抗德卢替康对HER2表达水平低于前代疗法的情况具有活性。初始HER2阴性乳腺癌患者脑转移灶中HER2的表达率尚不清楚，在未进行脑转移灶采样的情况下，晚期乳腺癌伴脑转移时的受体不一致情况可能会低估中枢神经系统的反应潜力。在这项队列研究中，纳入了136例患者，根据ASCO/CAP指南对401份样本进行评分，15/28例（54%）HER2阴性原发性乳腺癌患者在随后切除的脑转移灶中检测到HER2表达，这是一个显著的不一致群体。
