Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
Department of Medical Records, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
Breast. 2024 Feb;73:103669. doi: 10.1016/j.breast.2023.103669. Epub 2024 Jan 1.
A considerable number of patients with breast cancer will suffer from brain metastasis in the advanced setting. The HER2 status serves as a significant prognostic factor and the reference of applying treatment for patients with breast cancer brain metastasis (BCBM).
Between January 2010 and July 2021, patients with BCBM who had available HER2 status were identified. The patients with HER2 1+ in immunohistochemistry (IHC) or IHC 2+ and fluorescence in situ hybridization (FISH) negative were categorized as HER2-low. Comparisons were conducted between the HER2-low and HER2-zero population. The primary endpoint was overall survival (OS) after the diagnosis of BCBM. Survival outcomes were assessed using Kaplan-Meier curves with log-rank test and Cox proportional hazards model.
In this study, we analyzed 71 patients with the HER2-low breast cancer subtype and 64 patients with the HER2-zero subtype. Despite the limited sample size, our findings revealed a significantly better OS for patients with HER2-low cancer compared to their HER2-zero counterparts (26 m vs 20 m, p = 0.0017). This trend was particularly notable in the HR-negative group (26 m vs 13 m, p = 0.0078), whereas no significant difference was observed among the HR-positive patients. Furthermore, Cox regression analysis revealed that the HER2-low status was an independent prognostic factor for better survival in the HR-negative patients (p = 0.046 in multivariate analysis).
Patients diagnosed with HER2-low BCBM exhibited a more favorable prognosis than those with HER2-zero BCBM, particularly within the HR-negative subgroup. The low expression of HER2 is supposed to be linked to the prolonged survival of BCBM patients.
相当数量的乳腺癌患者在晚期会发生脑转移。HER2 状态是乳腺癌脑转移（BCBM）患者重要的预后因素和治疗参考。
本研究纳入了 2010 年 1 月至 2021 年 7 月间 HER2 状态可评估的 BCBM 患者。免疫组化（IHC）HER2 1+或 IHC 2+、荧光原位杂交（FISH）阴性的患者被归类为 HER2 低表达。比较了 HER2 低表达和 HER2 零表达人群。主要终点是 BCBM 诊断后的总生存（OS）。采用 Kaplan-Meier 曲线和对数秩检验及 Cox 比例风险模型评估生存结果。
本研究纳入了 71 例 HER2 低表达和 64 例 HER2 零表达的乳腺癌患者。尽管样本量有限，但我们发现 HER2 低表达患者的 OS 明显长于 HER2 零表达患者（26m vs 20m，p=0.0017）。这种趋势在 HR 阴性组中更为显著（26m vs 13m，p=0.0078），而在 HR 阳性患者中无显著差异。此外，Cox 回归分析显示，HER2 低表达状态是 HR 阴性患者生存的独立预后因素（多因素分析 p=0.046）。
与 HER2 零表达 BCBM 患者相比，HER2 低表达 BCBM 患者预后更好，特别是在 HR 阴性亚组中。HER2 低表达可能与 BCBM 患者的生存延长有关。
