不同的ER和PR表达模式会严重影响早期HER2阳性乳腺癌的临床预后：对871名接受新辅助治疗的患者进行的真实世界分析

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2024-04-11 DOI:10.1016/j.breast.2024.103733

Haizhu Chen , Xiujuan Gui , Ziwei Zhou , Fengxi Su , Chang Gong , Shunrong Li , Wei Wu , Nanyan Rao , Qiang Liu , Herui Yao

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引用次数: 0

摘要

导言尚未充分探讨不同的雌激素受体（ER）和孕激素受体（PR）表达模式对HER2阳性乳腺癌的肿瘤行为和治疗结果的影响。本研究旨在全面探讨在新辅助治疗中，HER2 阳性乳腺癌患者在不同 ER 和 PR 表达模式下的临床差异。方法这项回顾性分析纳入了 2011 年至 2022 年在我院接受新辅助治疗的 871 例 HER2 阳性乳腺癌患者。对三种激素受体（HR）特异性亚型进行了比较，即ER阴性/PR阴性/HER2阳性（ER-/PR-/HER2+）、单一HR阳性（HR+）/HER2+和三阳性乳腺癌（TPBC）亚型。结果在871名患者中，21.0%患有ER-/PR-/HER2+肿瘤，33.6%患有单一HR+/HER2+疾病，45.4%患有TPBC。与ER-/PR-/HER2+肿瘤患者相比，单发HR+/HER2+肿瘤患者和TPBC病例的病理完全反应率（pCR）明显较低（36.9% vs. 24.3% vs. 49.2%，p <0.001）。多变量分析证实，TPBC与pCR可能性降低显著相关（OR = 0.42, 95%CI 0.28-0.63, p <0.001）。包括无病生存期（DFS）和总生存期（OS）在内的生存结果显示，在整个患者群体中，不同HR特异性亚型之间没有明显差异。结论HER2阳性乳腺癌表现出三种不同的HR特异性亚型，其临床表现和治疗反应各不相同。这些发现为考虑ER和PR表达模式的个性化治疗策略提供了建议，强调了进一步研究揭示具有不同HR表达模式的HER2阳性乳腺癌的分子特征的必要性。

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Distinct ER and PR expression patterns significantly affect the clinical outcomes of early HER2-positive breast cancer: A real-world analysis of 871 patients treated with neoadjuvant therapy

Introduction

The impact of distinct estrogen receptor (ER) and progesterone receptor (PR) expression patterns on tumor behavior and treatment outcomes within HER2-positive breast cancer is not fully explored. This study aimed to comprehensively examine the clinical differences among patients with HER2-positive breast cancer harboring distinct ER and PR expression patterns in the neoadjuvant setting.

Methods

This retrospective analysis included 871 HER2-positive breast patients treated with neoadjuvant therapy at our hospital between 2011 and 2022. Comparisons were performed across the three hormone receptor (HR)-specific subtypes, namely the ER-negative/PR-negative/HER2-positive (ER-/PR-/HER2+), the single HR-positive (HR+)/HER2+, and the triple-positive breast cancer (TPBC) subtypes.

Results

Of 871 patients, 21.0% had ER-/PR-/HER2+ tumors, 33.6% had single HR+/HER2+ disease, and 45.4% had TPBC. Individuals with single HR+/HER2+ tumors and TPBC cases demonstrated significantly lower pathological complete response (pCR) rates compared to those with ER-/PR-/HER2+ tumors (36.9% vs. 24.3% vs. 49.2%, p < 0.001). Multivariate analysis confirmed TPBC as significantly associated with decreased pCR likelihood (OR = 0.42, 95%CI 0.28–0.63, p < 0.001). Survival outcomes, including disease-free survival (DFS) and overall survival (OS), showed no significant differences across HR-specific subtypes in the overall patient population. However, within patients without anti-HER2 therapy, TPBC was linked to improved DFS and a trend towards better OS.

Conclusions

HER2-positive breast cancer exhibited three distinct HR-specific subtypes with varying clinical manifestations and treatment responses. These findings suggest personalized treatment strategies considering ER and PR expression patterns, emphasizing the need for further investigations to unravel molecular traits underlying HER2-positive breast cancer with distinct HR expression patterns.

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.