全面评估 HER2 低与 HER2 零乳腺癌患者的免疫表型及其对生存结果的影响。

IF 3.3 4区 医学 Q2 ONCOLOGY
Breast Cancer : Targets and Therapy Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI:10.2147/BCTT.S476394
Heidi Chwan Ko, R J Seager, Sarabjot Pabla, Maria-Fernanda Senosain, Erik Van Roey, Shuang Gao, Kyle C Strickland, Rebecca Ann Previs, Michelle F Green, Maureen Cooper, Mary K Nesline, Stephanie B Hastings, Kobina Agyaful Amoah, Shengle Zhang, Jeffrey M Conroy, Taylor J Jensen, Marcia Eisenberg, Brian Caveney, Eric A Severson, Shakti Ramkissoon, Shipra Gandhi
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引用次数: 0

摘要

背景:自曲妥珠单抗(trastuzumab deruxtecan)问世以来,人们对HER2-低乳腺癌分子特征的认识不断发展。在此,我们探讨了肿瘤免疫微环境(TME)中免疫相关基因表达模式的差异以及HER2-低乳腺癌和HER2-零乳腺癌之间的生存情况:对129例晚期HER2阴性(免疫组化(IHC)0、1+或2+,原位杂交ERBB2扩增阴性)乳腺癌患者的FFPE样本进行了全面的基因组和免疫分析,包括395个免疫基因的RNA-seq基因表达评估。除 PD-L1 IHC 和 TMB 外,其他免疫生物标记物的 mRNA 表达均来自 RNA-seq。统计比较采用 Kruskal-Wallis 或 Wilcoxon Rank-Sum 检验或带连续性校正的双样本比例相等检验(显著性 p≤0.05)。采用 Kaplan-Meier 分析法计算生存率差异(显著性 p≤0.05 ):结果:免疫相关基因的mRNA表达在HER2-低乳腺癌和HER2-零乳腺癌之间没有明显差异。然而,HER2-低乳腺癌与较高比例的ER阳性相关。当ER与HER2一起分析时,我们观察到HER2-零/ER阴性肿瘤的肿瘤免疫原性特征(TIGS)表达明显高于HER2-低/ER阳性肿瘤(P=0.0088)。同样,与HER2-0/ER-阴性肿瘤相比,HER2-低/ER-阳性肿瘤中PD-L1和T细胞免疫球蛋白和ITIM结构域(TIGIT)mRNA的表达较低(p=0.014和0.012)。与HER2-0肿瘤患者相比,HER2-低肿瘤患者的中位OS更长(94个月 vs 42个月,p=0.0044):结论:与HER2为零的乳腺癌患者相比,HER2低的乳腺癌患者生存期更长,但在免疫相关基因表达方面却没有差异。生存期的差异可归因于 HER2 低乳腺癌患者的 ER 阳性率高于 HER2 零肿瘤患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive Assessment of Immune Phenotype and Its Effects on Survival Outcomes in HER2-Low versus HER2-Zero Breast Cancer.

Background: The understanding of molecular characteristics of HER2-low breast cancer is evolving since the establishment of trastuzumab deruxtecan. Here, we explore the differences in expression patterns of immune-related genes in the tumor immune microenvironment (TME) and survival between HER2-low and HER2-zero breast cancers.

Methods: Comprehensive genomic and immune profiling, including RNA-seq gene expression assessment of 395 immune genes, was performed on FFPE samples from 129 patients with advanced HER2-negative (immunohistochemistry (IHC) 0, 1+ or 2+ with negative ERBB2 amplification by in-situ hybridization) breast cancer. Both estrogen receptor (ER) and HER2 statuses were obtained from available pathology reports. mRNA expressions of immune biomarkers, except for PD-L1 IHC and TMB, were derived from RNA-seq. Statistical comparisons were performed using the Kruskal-Wallis or Wilcoxon Rank-Sum test or the two-sample test for equality of proportions with continuity correction (p≤0.05 for significance). Survival differences were calculated using Kaplan-Meier analysis (p≤0.05 for significance).

Results: There were no significant differences in mRNA expressions of immune-related genes between HER2-low and HER2-zero breast cancers. However, HER2-low breast cancers were associated with a higher proportion of ER-positivity. When ER was analyzed along with HER2, we observed a significantly higher tumor immunogenic signature (TIGS) expression in HER2-zero/ER-negative tumors than in HER2-low/ER-positive tumors (p=0.0088). Similarly, lower expression of PD-L1 and T cell immunoglobulin and ITIM domain (TIGIT) mRNA was observed in HER2-low/ER-positive tumors when compared to HER2-zero/ER-negative tumors (p=0.014 and 0.012, respectively). Patients with HER2-low tumors had a longer median OS than those with HER2-zero tumors (94 months vs 42 months, p=0.0044).

Conclusion: Patients with HER2-low breast cancer have longer survivals yet display no differences in immune-related gene expression when compared to those with HER2-zero cancers. The differences in survival can be attributed to the higher rate of ER-positivity seen in HER2-low breast cancers, compared to HER2-zero tumors.

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