Clinical outcomes of early-stage triple-negative breast cancer after neoadjuvant chemotherapy according to HER2-low status☆
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View abstract on PubMed
Summary
This summary is machine-generated.In early-stage triple-negative breast cancer (eTNBC) treated with neoadjuvant therapy (NAT), HER2-low expression did not impact pathological complete response or survival outcomes. HER2 status discordance highlights challenges in quantification and tumor heterogeneity.
Area Of Science
- Oncology
- Breast Cancer Research
- Molecular Diagnostics
Background
- The prognostic significance of human epidermal growth factor receptor 2 (HER2) expression in early-stage triple-negative breast cancer (eTNBC) remains uncertain.
- Immunohistochemistry (IHC) is commonly used to assess HER2 status, but its impact in the context of neoadjuvant therapy (NAT) requires further clarification.
Purpose Of The Study
- To investigate the association between HER2 expression levels (HER2-low vs. HER2 IHC score 0) and treatment outcomes in patients with eTNBC receiving NAT.
- To evaluate the impact of HER2 status on pathological complete response (pCR) and long-term survival.
Main Methods
- A multi-institutional cohort of 977 patients with stage I-III TNBC treated with NAT and surgery (2016-2019) was analyzed.
- HER2 expression was categorized as HER2-low (IHC 1+ or 2+/FISH not amplified) or HER2 IHC score 0.
- Pathological complete response (pCR) rates were compared using logistic regression, and survival outcomes were analyzed with Kaplan-Meier and Cox models.
Main Results
- HER2-low tumors (39.7%) were associated with higher baseline nodal positivity compared to HER2 IHC score 0 tumors (46.6%).
- pCR rates were similar between HER2-low (32.0%) and HER2 IHC score 0 (32.6%) groups (adjusted P=0.924).
- Recurrence-free survival (RFS), distant RFS (DRFS), and overall survival (OS) did not significantly differ between HER2 categories, regardless of residual disease after NAT.
Conclusions
- HER2-low status in eTNBC treated with NAT is not significantly associated with pCR or survival outcomes.
- Observed discordance in HER2 IHC status pre- and post-NAT suggests challenges in HER2 quantification and reflects tumor heterogeneity.
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