Shao Yingbo, Guan Huijuan, Luo Zhifen, Yu Yang, He Yaning, Chen Qi, Liu Chaojun, Zhu Fangyuan, Liu Hui
Department of Breast Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
Department of Breast Oncology, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China.
Front Oncol. 2025 Mar 5;15:1459444. doi: 10.3389/fonc.2025.1459444. eCollection 2025.
The present study aimed to evaluate the predictive factors that predict outcomes of HER2-low breast cancer patients who did not achieve pathological complete response(pCR) after neoadjuvant chemotherapy (NAC).
This study included patients with HER2-low breast cancer who received NAC from January 2017 to December 2020. Analysis of the clinicopathological features, NAC response and outcome of the patients were retrospectively analyzed. Univariate and multivariable Cox analysis were used to determine factors that predict outcomes of HER2-low breast cancer patients who did not exhibit pCR.
293 Asian patients were included. The proportion of patients with hormone receptor (HR) positive and triple negative breast cancer (TNBC) among HER2-low patients was 75.8% and 24.2%, respectively. The pCR rate of HR positive cases was significantly lower than TNBC (27.5% vs. 53.5%, P=0.000). The patients who obtained pCR after NAC showed better disease-free survival(DFS) (5-year DFS 93.9% vs. 83.1%, p=0.039). For patients not achieving pCR, multivariable analysis showed that Miller/Payne (MP) grading system (hazard ratio: 0.094; 95% CI: 0.037-0.238; p=0.000) and HR status (hazard ratio: 2.561; 95% CI: 1.100-5.966; p=0.029) were significant independent predictors for DFS. Additionally, The MP grading system was also an independent predictor of overall survival (OS) (hazard ratio: 0.071; 95% CI: 0.019-0.260; p=0.000).
The results of our study show that pathological assessment following NAC offers valuable insights into the survival outcome of HER2-low breast cancer. According to these findings, responses to NAC should be considered when choosing systemic treatment for patients with HER2-low breast cancer.
本研究旨在评估预测新辅助化疗（NAC）后未达到病理完全缓解（pCR）的HER2低表达乳腺癌患者预后的因素。
本研究纳入了2017年1月至2020年12月期间接受NAC的HER2低表达乳腺癌患者。对患者的临床病理特征、NAC反应和预后进行回顾性分析。采用单因素和多因素Cox分析来确定预测未出现pCR的HER2低表达乳腺癌患者预后的因素。
纳入了293例亚洲患者。HER2低表达患者中激素受体（HR）阳性和三阴性乳腺癌（TNBC）患者的比例分别为75.8%和24.2%。HR阳性病例的pCR率显著低于TNBC（27.5%对53.5%，P = 0.000）。NAC后获得pCR的患者显示出更好的无病生存期（DFS）（5年DFS 93.9%对83.1%，p = 0.039）。对于未达到pCR的患者，多因素分析显示米勒/佩恩（MP）分级系统（风险比：0.094；95%置信区间：0.037 - 0.238；p = 0.000）和HR状态（风险比：2.561；95%置信区间：1.100 - 5.966；p = 0.029）是DFS的显著独立预测因素。此外，MP分级系统也是总生存期（OS）的独立预测因素（风险比：0.071；95%置信区间：0.019 - 0.260；p = 0.000）。
我们的研究结果表明，NAC后的病理评估为HER2低表达乳腺癌的生存结局提供了有价值的见解。根据这些发现，在为HER2低表达乳腺癌患者选择全身治疗时应考虑对NAC的反应。
