Park Woong Ki, Nam Seok Jin, Kim Seok Won, Lee Jeong Eon, Yu Jonghan, Lee Se Kyung, Ryu Jai Min, Chae Byung Joo
Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea.
Cancers (Basel). 2024 Jul 17;16(14):2566. doi: 10.3390/cancers16142566.
TNBC is noted for its aggressive behavior and poor prognosis. Recently developed HER2 target agents have shown potential benefit even in HER2-low expressing breast cancers. This study retrospectively analyzed 2542 non-metastatic TNBC patients from 2008 to 2020, revealing that 26.0% were HER2-low. Data on demographics, tumor characteristics, pathologic complete response (pCR) rates and disease-free survival (DFS), distant metastasis-free survival (DMFS), overall survival (OS), and breast cancer-specific survival (BCSS) were analyzed. The HER2-low group, compared to the HER2-0 group, showed significantly better DFS, DMFS, OS, BCSS ( = 0.0072, = 0.0096, = 0.0180, and = 0.0001, respectively) with older age and higher rates of postmenopausal status ( < 0.0001). No significant differences in pCR rates were observed. Multivariate analyses identified HER2 status as a significant prognostic factor for DFS ( = 0.048), DMFS ( = 0.018), OS ( = 0.049), and BCSS ( = 0.008). Subgroup analysis revealed that these effects varied with menopausal status, showing more pronounced benefits in postmenopausal women. Our findings suggest that HER2-low TNBC patients exhibit a distinct clinical profile and improved survival compared to HER2-0 TNBC patients, especially in postmenopausal patients. Further research on estrogen and HER2 interaction is needed.
三阴性乳腺癌（TNBC）以其侵袭性生物学行为和不良预后而闻名。最近研发的HER2靶向药物即使在HER2低表达的乳腺癌中也显示出潜在益处。本研究回顾性分析了2008年至2020年的2542例非转移性TNBC患者，发现26.0%为HER2低表达。分析了人口统计学、肿瘤特征、病理完全缓解（pCR）率、无病生存期（DFS）、无远处转移生存期（DMFS）、总生存期（OS）和乳腺癌特异性生存期（BCSS）的数据。与HER2 0组相比，HER2低表达组的DFS、DMFS、OS、BCSS显著更好（分别为 = 0.0072、 = 0.0096、 = 0.0180和 = 0.0001），年龄更大且绝经后状态发生率更高（ < 0.0001）。未观察到pCR率有显著差异。多因素分析确定HER2状态是DFS（ = 0.048）、DMFS（ = 0.018）、OS（ = 0.049）和BCSS（ = 0.008）的显著预后因素。亚组分析显示，这些影响因绝经状态而异，在绝经后女性中益处更为明显。我们的研究结果表明，与HER2 0 TNBC患者相比，HER2低表达TNBC患者表现出独特的临床特征且生存期改善，尤其是在绝经后患者中。需要对雌激素与HER2的相互作用进行进一步研究。
