Prognostic Value of the Evolution of HER2-Low Expression after Neoadjuvant Chemotherapy / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer can benefit from trastuzumab deruxtecan. Given the unclear prognostic characteristics of HER2-low breast cancer, we investigated the prognostic characteristics of HER2-low expression from primary tumor to residual disease after neoadjuvant chemotherapy (NACT). @*Materials and Methods@#The data of HER2-negative patients receiving NACT at our center were collected. Pathological complete response (pCR) rate were compared between HER2-0 and HER2-low patients. The evolution of HER2 expression from primary tumor to residual disease and its impact on disease-free survival (DFS) were examined. @*Results@#Of the 690 patients, 494 patients had HER2-low status, of which 72.3% were hormone receptor (HR)–positive (p < 0.001). The pCR rates of HER2-low and HER2-0 patients (14.2% vs. 23.0%) showed no difference in multivariate analysis regardless of HR status. No association was observed between DFS and HER2 status. Of the 564 non-pCR patients, 57 (10.1%) changed to HER2-positive, and 64 of the 150 patients (42.7%) with HER2-0 tumors changed to HER2-low. HER2-low (p=0.004) and HR-positive (p=0.010) tumors before NACT were prone to HER2 gain. HER2 gain patients had a better DFS compared with HER2-negative maintained patients (87.9% vs. 79.5%, p=0.048), and the DFS of targeted therapy group was better than that of no targeted therapy group (92.4% vs. 66.7%, p=0.016). @*Conclusion@#Although HER2-low did not affect the pCR rate and DFS, significant evolution of HER2-low expression after NACT creates opportunities for targeted therapy including trastuzumab.

Advances in predictive factors of neoadjuvant chemotherapy in breast cancer / 国际肿瘤学杂志

Predictive factors of neoadjuvant chemotherapy play an important role in selecting sensitive chemotherapy regimen and avoiding unsuitable regimen for breast cancer patients. At present, estrogen receptor (ER), progestin receptor (PR) and HER-2 status are the main predictive factors. Other factors such as Ki-67 also seem to be promising for optimizing neoadjuvant chemotherapy.