Departamento de Cirugía Oncológica, Universidad de Antioquia, Medellín, Colombia.
Departamento de Cirugía Oncológica, Universidad de Antioquia, Medellín, Colombia; Instituto de Cancerología Las Américas Auna, Medellín, Colombia.
Biomedica. 2023 Sep 30;43(3):396-405. doi: 10.7705/biomedica.6665.
Breast cancer is the most common type of cancer and the leading cause of death by cancer in women in Colombia. Approximately 15 to 20% of breast cancers overexpress HER2.
To analyze the relationship between multiple clinical and histological variables and pathological complete response in patients with HER2-positive breast cancer undergoing neoadjuvant therapy in a specialized cancer center in Colombia.
We performed a retrospective analysis of non-metastatic HER2-positive breast cancer patients who received neoadjuvant therapy between 2007 and 2020 at the Instituto de Cancerología Las Americas Auna (Medellín, Colombia). Assessed parameters were tumor grade, proliferation index, estrogen receptor, progesterone receptor, HER2 status, type of neoadjuvant therapy, pathologic complete response rates, and overall survival.
Variables associated with low pathologic complete response rates were tumor grades 1-2 (OR = 0.55; 95% CI = 0.37-0.81; p = 0.03), estrogen receptor positivity (OR =0.65; 95%; CI = 0.43-0.97; p=0.04), and progesterone receptor positivity (OR = 0.44; 95% CI = 0.29-0.65; p = 0.0001). HER2 strong positivity (score 3+) was associated with high pathological complete response rates (OR = 3.3; 95% CI = 1.3-8.35; p=0.013). Five-year overall survival was 91.5% (95% CI = 82.6-95.9) in patients with pathological complete response and 73.6% (95% CI = 66.4-79.6) in patients who did not achieve pathological complete response (p = 0.001). Additionally, the pathological complete response rate was three times higher in patients receiving combined neoadjuvant chemotherapy with anti-HER2 therapy than in those with chemotherapy alone (48% versus 16%).
In patients with HER2-positive breast cancer, tumor grade 3, estrogen receptor negativity, progesterone receptor negativity, strong HER2 positivity (score 3+), and the use of the neoadjuvant trastuzumab are associated with higher pathological complete response rates.
乳腺癌是最常见的癌症类型，也是哥伦比亚女性癌症死亡的主要原因。大约 15%至 20%的乳腺癌过度表达 HER2。
分析在哥伦比亚一家专门的癌症中心接受新辅助治疗的 HER2 阳性乳腺癌患者的多个临床和组织学变量与病理完全缓解之间的关系。
我们对 2007 年至 2020 年在哥伦比亚拉斯美洲癌症研究所（麦德林）接受新辅助治疗的非转移性 HER2 阳性乳腺癌患者进行了回顾性分析。评估的参数包括肿瘤分级、增殖指数、雌激素受体、孕激素受体、HER2 状态、新辅助治疗类型、病理完全缓解率和总生存率。
病理完全缓解率较低的变量包括肿瘤分级 1-2（OR = 0.55；95%CI = 0.37-0.81；p = 0.03）、雌激素受体阳性（OR = 0.65；95%CI = 0.43-0.97；p = 0.04）和孕激素受体阳性（OR = 0.44；95%CI = 0.29-0.65；p = 0.0001）。HER2 强阳性（评分 3+）与高病理完全缓解率相关（OR = 3.3；95%CI = 1.3-8.35；p = 0.013）。病理完全缓解患者的 5 年总生存率为 91.5%（95%CI = 82.6-95.9），未达到病理完全缓解的患者为 73.6%（95%CI = 66.4-79.6）（p = 0.001）。此外，与单独接受化疗的患者相比，接受曲妥珠单抗联合新辅助化疗的患者病理完全缓解率高 3 倍（48%对 16%）。
在 HER2 阳性乳腺癌患者中，肿瘤分级 3 级、雌激素受体阴性、孕激素受体阴性、HER2 强阳性（评分 3+）和新辅助曲妥珠单抗的使用与更高的病理完全缓解率相关。
