Yousef Einas M, Alswilem Abdullah Mansour, Alfaraj Zahrah S, Alhamood Danya J, Ghashi Ghfran K, Alruwaily Hanan S, Al Yahya Shouq S, Alsaeed Eyad
College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
Oncology Center, King Saud University Medical City, Riyadh 19910, Saudi Arabia.
Medicina (Kaunas). 2025 Mar 22;61(4):563. doi: 10.3390/medicina61040563.
: Changes in biomarker status are not rare and usually occur in an unfavorable direction. Evaluating changes in biomarker status is advantageous for assessing treatment options and prognosticating patients. Currently, only a few studies have explored the association between biomarker conversion and breast cancer relapse. In this study, we sought to determine the incidence of receptor conversions in patients diagnosed with recurrent breast cancer in comparison to their corresponding primary tumors and to evaluate possible influencing factors. Moreover, we aimed to assess the prognostic significance of biomarker conversion, if any was detected, in breast cancer patients. : A retrospective cohort study was conducted among breast cancer patients treated at King Khalid University Hospital, Riyadh, Saudi Arabia. Data were collected from recurrent breast cancer patients about different parameters to assess the incidence of hormonal receptors and human epidermal growth factor 2 (HER2) status conversion between primary and recurrent tumors. The calculation of progression-free survival (PFS)/ relapse-free survival (RFS) and the overall survival (OS) was conducted to assess the prognostic value of the assessed biomarker conversion. : Progesterone receptor (PR) conversion had the highest incidence (29.9%), followed by HER2 (23%) and estrogen receptor (ER) (12.6%). Menopausal status and concurrent receptor conversion were significant factors influencing receptor status changes. However, no significant associations were found between receptor conversion and other clinical factors, including tumor stage and histological subtype. The survival analysis revealed no statistically significant differences in OS or RFS between patients with and without receptor conversion. : Receptor conversion, particularly for PR and HER2, is common in recurrent breast cancer, emphasizing the importance of re-biopsy at recurrence to ensure accurate treatment decisions. While receptor conversion does not significantly impact survival outcomes in this cohort, further large-scale prospective studies are warranted to validate these findings and explore their clinical implications in breast cancer management.
生物标志物状态的变化并不罕见，且通常朝着不利的方向发展。评估生物标志物状态的变化有助于评估治疗方案和预测患者预后。目前，仅有少数研究探讨了生物标志物转换与乳腺癌复发之间的关联。在本研究中，我们试图确定复发性乳腺癌患者与其相应原发性肿瘤相比受体转换的发生率，并评估可能的影响因素。此外，我们旨在评估生物标志物转换（若检测到）在乳腺癌患者中的预后意义。
在沙特阿拉伯利雅得的哈立德国王大学医院接受治疗的乳腺癌患者中进行了一项回顾性队列研究。收集了复发性乳腺癌患者关于不同参数的数据，以评估原发性肿瘤和复发性肿瘤之间激素受体及人表皮生长因子2（HER2）状态转换的发生率。计算无进展生存期（PFS）/无复发生存期（RFS）和总生存期（OS），以评估所评估的生物标志物转换的预后价值。
孕激素受体（PR）转换的发生率最高（29.9%），其次是HER2（23%）和雌激素受体（ER）（12.6%）。绝经状态和同时发生的受体转换是影响受体状态变化的重要因素。然而，在受体转换与其他临床因素（包括肿瘤分期和组织学亚型）之间未发现显著关联。生存分析显示，有受体转换和无受体转换的患者在OS或RFS方面无统计学显著差异。
受体转换，尤其是PR和HER2的转换，在复发性乳腺癌中很常见，这强调了在复发时重新活检以确保准确治疗决策的重要性。虽然受体转换在本队列中对生存结果没有显著影响，但仍需要进一步的大规模前瞻性研究来验证这些发现，并探索其在乳腺癌管理中的临床意义。
