Impact of HER2-low status for patients with early-stage breast cancer and non-pCR after neoadjuvant chemotherapy: a National Cancer Database Analysis.
| dc.contributor.author | Li, Huiyue | |
| dc.contributor.author | Plichta, Jennifer K | |
| dc.contributor.author | Li, Kan | |
| dc.contributor.author | Jin, Yizi | |
| dc.contributor.author | Thomas, Samantha M | |
| dc.contributor.author | Ma, Fei | |
| dc.contributor.author | Tang, Li | |
| dc.contributor.author | Wei, Qingyi | |
| dc.contributor.author | He, You-Wen | |
| dc.contributor.author | Chen, Qichen | |
| dc.contributor.author | Guo, Yuanyuan | |
| dc.contributor.author | Liu, Yueping | |
| dc.contributor.author | Zhang, Jian | |
| dc.contributor.author | Luo, Sheng | |
| dc.date.accessioned | 2024-01-02T03:34:22Z | |
| dc.date.available | 2024-01-02T03:34:22Z | |
| dc.date.issued | 2023-12 | |
| dc.description.abstract | PurposeTo investigate potential differences in pathological complete response (pCR) rates and overall survival (OS) between HER2-low and HER2-zero patients with early-stage hormone receptor (HR)-positive and triple-negative breast cancer (TNBC), in the neoadjuvant chemotherapy setting.MethodsWe identified early-stage invasive HER2-negative BC patients who received neoadjuvant chemotherapy diagnosed between 2010 and 2018 in the National Cancer Database. HER2-low was defined by immunohistochemistry (IHC) 1+ or 2+ with negative in situ hybridization, and HER2-zero by IHC0. All the methods were applied separately in the HR-positive and TNBC cohorts. Logistic regression was used to estimate the association of HER2 status with pCR (i.e. ypT0/Tis and ypN0). Kaplan-Meier method and Cox proportional hazards model were applied to estimate the association of HER2 status with OS. Inverse probability weighting and/or multivariable regression were applied to all analyses.ResultsFor HR-positive patients, 70.9% (n = 17,934) were HER2-low, whereas 51.1% (n = 10,238) of TNBC patients were HER2-low. For both HR-positive and TNBC cohorts, HER2-low status was significantly associated with lower pCR rates [HR-positive: 5.0% vs. 6.7%; weighted odds ratio (OR) = 0.81 (95% CI: 0.72-0.91), p < 0.001; TNBC: 21.6% vs. 24.4%; weighted OR = 0.91 (95% CI: 0.85-0.98), p = 0.007] and improved OS [HR-positive: weighted hazard ratio = 0.85 (95% CI: 0.79-0.91), p < 0.001; TNBC: weighted hazard ratio = 0.91 (95% CI: 0.86-0.96), p < 0.001]. HER2-low status was associated with favorable OS among patients not achieving pCR [HR-positive: adjusted hazard ratio = 0.83 (95% CI: 0.77-0.89), p < 0.001; TNBC: adjusted hazard ratio = 0.88 (95% CI 0.83-0.94), p < 0.001], while no significant difference in OS was observed in patients who achieved pCR [HR-positive: adjusted hazard ratio = 1.00 (95% CI: 0.61-1.63), p > 0.99; TNBC: adjusted hazard ratio = 1.11 (95% CI: 0.85-1.45), p = 0.44].ConclusionIn both early-stage HR-positive and TNBC patients, HER2-low status was associated with lower pCR rates. HER2-zero status might be considered an adverse prognostic factor for OS in patients not achieving pCR. | |
| dc.identifier | 10.1007/s10549-023-07171-z | |
| dc.identifier.issn | 0167-6806 | |
| dc.identifier.issn | 1573-7217 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Springer Science and Business Media LLC | |
| dc.relation.ispartof | Breast cancer research and treatment | |
| dc.relation.isversionof | 10.1007/s10549-023-07171-z | |
| dc.rights.uri | ||
| dc.subject | HER2-low | |
| dc.subject | HER2-zero | |
| dc.subject | Hormone receptor-positive breast cancer | |
| dc.subject | Overall survival | |
| dc.subject | Pathological complete response | |
| dc.subject | Triple-negative breast cancer | |
| dc.title | Impact of HER2-low status for patients with early-stage breast cancer and non-pCR after neoadjuvant chemotherapy: a National Cancer Database Analysis. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Plichta, Jennifer K|0000-0002-7411-0558 | |
| duke.contributor.orcid | Wei, Qingyi|0000-0002-3845-9445|0000-0003-4115-4439 | |
| duke.contributor.orcid | He, You-Wen|0000-0002-8983-2684 | |
| duke.contributor.orcid | Luo, Sheng|0000-0003-4214-5809 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Surgery | |
| pubs.organisational-group | Medicine, Medical Oncology | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.organisational-group | Institutes and Provost's Academic Units | |
| pubs.organisational-group | University Institutes and Centers | |
| pubs.organisational-group | Duke Global Health Institute | |
| pubs.organisational-group | Population Health Sciences | |
| pubs.organisational-group | Surgical Oncology | |
| pubs.organisational-group | Biostatistics & Bioinformatics, Division of Biostatistics | |
| pubs.publication-status | Published |
Files
Original bundle
- Name:
- 2023Li_et_al2023BCRT_HER2-low.pdf
- Size:
- 2 MB
- Format:
- Adobe Portable Document Format
- Description:
- Published version