HER2 低表达与 HER2 零表达乳腺癌患者新辅助化疗后生存结局的比较：一项荟萃分析。

Survival outcomes in HER2-low versus HER2-zero breast cancer after neoadjuvant chemotherapy: a meta-analysis.

机构信息

The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 150 meters north of the intersection of Xinjiayuan North Road and Xinjin Road Xinjin Road, Binhai New District, Tianjin, 300060, China.

Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, 300060, China.

出版信息

World J Surg Oncol. 2024 Apr 20;22(1):106. doi: 10.1186/s12957-024-03382-w.

BACKGROUND

The survival outcomes in HER2-low versus HER2-zero breast cancer (BC) after neoadjuvant chemotherapy (NACT) remain unclear. The meta-analysis was conducted to summarize current evidence about the survival outcomes in HER2-low versus HER2-zero BC.

METHODS

We conducted a systematic search in PubMed and EMBASE databases to identify relevant studies.

RESULTS

A total of 14 studies with 53,714 patients were included. Overall, 34,037 patients (63.37%) were HER2-low, and 19,677 patients (36.63%) were HER2-zero. Patients with HER2-low tumors had a significantly lower pathological complete response (pCR) rate than patients with HER2-zero tumors, regardless of the hormone receptor status. Compared with HER2-zero breast cancer, the overall survival (OS) and disease-free survival (DFS) of HER2-low BC were longer in the overall cohort (HR = 0.72; 95% CI = 0.61-0.85; P < 0.0001; HR = 0.83; 95% CI = 0.75-0.92; P = 0.0002); however, no differences were observed in terms of OS and DFS between HER2-low and HER2-zero BC in the HR-negative group. In the HR-positive group, HER2-low status had no significant impact on OS, while significantly associated with increased DFS (HR = 0.85; 95% CI = 0.76-0.96; P = 0.007).

CONCLUSION

These results suggest that although HER2-low BC has a poor response to NACT, it is correlated with favorable OS and DFS after NACT in the overall cohort as well as longer DFS in the HR-positive group.

背景

接受新辅助化疗（NACT）后，HER2 低表达与 HER2 零表达乳腺癌（BC）的生存结局仍不清楚。本荟萃分析旨在总结目前关于 HER2 低表达与 HER2 零表达 BC 生存结局的证据。

方法

我们在 PubMed 和 EMBASE 数据库中进行了系统检索，以确定相关研究。

结果

共纳入 14 项研究，包含 53714 例患者。总体而言，34037 例（63.37%）患者为 HER2 低表达，19677 例（36.63%）患者为 HER2 零表达。HER2 低表达肿瘤患者的病理完全缓解（pCR）率明显低于 HER2 零表达肿瘤患者，而与激素受体状态无关。与 HER2 零表达乳腺癌相比，HER2 低表达 BC 的总生存（OS）和无病生存（DFS）在总队列中更长（HR=0.72；95%CI=0.61-0.85；P<0.0001；HR=0.83；95%CI=0.75-0.92；P=0.0002）；然而，在 HR 阴性组中，HER2 低表达与 HER2 零表达 BC 的 OS 和 DFS 无差异。在 HR 阳性组中，HER2 低状态对 OS 没有显著影响，但与 DFS 的增加显著相关（HR=0.85；95%CI=0.76-0.96；P=0.007）。