用 IHC3 评分预测结节阴性、激素受体阳性、HER2 阴性早期乳腺癌患者的预后。

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2024-10-26 DOI:10.1016/j.esmoop.2024.103963

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引用次数: 0

摘要

背景：预后已被用于确定可能从治疗降级中获益的患者群体。对于激素受体阳性（HRpos）、人表皮生长因子受体 2 阴性（HER2 阴性）的早期乳腺癌（eBC）患者，降级治疗通常包括放弃化疗。由于最近开发的专门疗法需要亲自动手处理副作用，治疗格局正在发生变化，治疗决策不再仅仅基于预后，还要考虑潜在的副作用。因此，根据预后确定患者群体变得越来越重要：在这项回顾性分析中，从 2002 年至 2021 年期间在德国弗兰肯大学乳腺中心接受治疗的所有患者中选取了 2359 名结节阴性 HRpos/HER2neg eBC 患者。研究评估了IHC3评分（包括雌激素和孕激素受体状态及Ki-67的免疫组化测量）与临床参数（淋巴结状态、肿瘤分期、分级）在无侵袭性疾病生存期（iDFS）和总生存期（OS）方面的预后价值：结果：IHC3与Ki-67表达呈正相关，与激素受体表达呈反相关。按四分位数划分的IHC3可确定预后较差的患者：最高与最低四分位数患者的5年和10年iDFS率分别为84%对95%和70%对88%。远处无病生存的敏感性分析显示出与 iDFS 相似的结果。最高四分位数与最低四分位数患者的5年和10年OS率分别为92%对97%和81%对92%：结论：IHC3能确定结节阴性、HRpos/HER2阴性eBC患者的预后分组。IHC3评分较高的结节阴性患者预后最差，与近期试验中描述的结节阳性患者预后相当。因此，这种简单而经济有效的工具有可能帮助确定采用创新治疗方法的患者群体。

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Prognosis prediction with the IHC3 score in patients with node-negative, hormone receptor-positive, HER2-negative early breast cancer

Background

Prognostication has been used to identify patient populations that could potentially benefit from treatment de-escalation. In patients with hormone receptor-positive (HRpos), human epidermal growth factor receptor 2-negative (HER2neg) early breast cancer (eBC), treatment de-escalation classically involved omitting chemotherapy. With recently developed specialized therapies that require hands-on side-effect management, the therapeutic landscape is changing and therapy decisions are no longer based only on prognosis, but also consider potential side-effects. Therefore, identification of patient groups based on prognostication has gained importance.

Materials and methods

In this retrospective analysis, a population of 2359 node-negative HRpos/HER2neg eBC patients was selected from all patients treated at the University Breast Center of Franconia, Germany between 2002 and 2021. The prognostic value of the IHC3 score (incorporating immunohistochemical measurements of the estrogen and progesterone receptor status and Ki-67) with clinical parameters (lymph node status, tumor stage, grading) regarding invasive disease-free survival (iDFS) and overall survival (OS) was assessed.

Results

IHC3 positively correlated with Ki-67 expression and inversely correlated with hormone receptor expression. IHC3 categorized into quartiles identified patients with a more unfavorable prognosis: 5-year and 10-year iDFS rates for patients in the highest versus the lowest quartile were 84% versus 95% and 70% versus 88%, respectively. A sensitivity analysis of distant disease-free survival showed similar results to those of iDFS. Five-year and 10-year OS rates for patients in the highest versus the lowest quartile were, respectively, 92% versus 97% and 81% versus 92%.

Conclusions

IHC3 is able to define prognostic groups in patients with node-negative, HRpos/HER2neg eBC. Node-negative patients with a high IHC3 score had the worst prognosis, which was comparable to that of node-positive patients described in recent trials. This simple and cost-effective tool could thus potentially aid in identifying patient groups for innovative therapeutic approaches.

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.