Liu Jing-Jing, Zhang Yi, Zhang Shi-Chao, Liu Xu, Wang Shu-Nan, Liu Xin-Yu, Zhang Jin
The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Front Cell Dev Biol. 2024 Nov 22;12:1417271. doi: 10.3389/fcell.2024.1417271. eCollection 2024.
The aim of this paper was to assess the differences in clinicopathological characteristics, efficacy and prognosis of neoadjuvant chemotherapy (NAC) in human epidermal growth factor receptor2(HER2)-zero and HER2-low hormone receptor (HR)-negative breast cancer (BC) patients, and the impact of HER2-evolution on prognosis before and after NAC. 319 triple negative breast cancer (TNBC) patients who completed NAC and surgery from August 2014 to August 2018 at Tianjin Medical University Cancer Institute and Hospital were included. Clinicopathological features, efficacy of NAC and assessment of prognosis were retrospectively analysed. The evolution of HER2-zero to HER2-low after NAC is defined as HER2-gain, the evolution of HER2-low to HER2-zero after NAC is defined as HER2-loss, and HER2 unchanged after NAC is defined as HER2-stable. In HR-negative BC, the pathological complete response (pCR) rate was significantly higher in HER2-zero compared with HER2-low patients, and the difference was statistically significant (38.9% vs 23.2%, = 0.004), but there was no significant difference in the prognosis between the two groups. The overall rate of HER2-evolution after NAC was 19.7%, and there was a significant correlation between HER2-loss and histological grading, whereas HER2-gain was significantly associated with Ki-67 expression. In terms of prognosis, HER2-gain was better compared to the other two groups. In this study, we found that HER2-low HR-negative BC showed different clinicopathological features and response to NAC compared with HER2-zero, as well as HER2-evolution before and after NAC had a significant impact on prognosis.
本文旨在评估新辅助化疗（NAC）在人表皮生长因子受体2（HER2）阴性和HER2低表达激素受体（HR）阴性乳腺癌（BC）患者中的临床病理特征、疗效和预后差异，以及HER2演变对NAC前后预后的影响。纳入了2014年8月至2018年8月在天津医科大学肿瘤医院完成NAC和手术的319例三阴性乳腺癌（TNBC）患者。对临床病理特征、NAC疗效和预后评估进行回顾性分析。NAC后HER2阴性变为HER2低表达定义为HER2获得，NAC后HER2低表达变为HER2阴性定义为HER2丢失，NAC后HER2无变化定义为HER2稳定。在HR阴性乳腺癌中，HER2阴性患者的病理完全缓解（pCR）率显著高于HER2低表达患者，差异有统计学意义（38.9%对23.2%，P = 0.004），但两组预后无显著差异。NAC后HER2演变的总体发生率为19.7%，HER2丢失与组织学分级显著相关，而HER2获得与Ki-67表达显著相关。在预后方面，HER2获得组优于其他两组。在本研究中，我们发现HER2低表达HR阴性乳腺癌与HER2阴性相比表现出不同的临床病理特征和对NAC的反应，以及NAC前后的HER2演变对预后有显著影响。
