Karen Van Baelen, Ha-Linh Nguyen, François Richard, Gitte Zels, Maria Margarete Karsten, Guilherme Nader-Marta, Peter Vermeulen, Luc Dirix, Adam David Dordevic, Evandro de Azambuja, Denis Larsimont, Marion Maetens, Elia Biganzoli, Hans Wildiers, Ann Smeets, Ines Nevelsteen, Patrick Neven, Giuseppe Floris, Christine Desmedt
{"title":"早期浸润性小叶性乳腺癌患者her2 -低水平与临床病理特征的关系:一项国际多中心研究","authors":"Karen Van Baelen, Ha-Linh Nguyen, François Richard, Gitte Zels, Maria Margarete Karsten, Guilherme Nader-Marta, Peter Vermeulen, Luc Dirix, Adam David Dordevic, Evandro de Azambuja, Denis Larsimont, Marion Maetens, Elia Biganzoli, Hans Wildiers, Ann Smeets, Ines Nevelsteen, Patrick Neven, Giuseppe Floris, Christine Desmedt","doi":"10.1186/s13058-025-02058-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The antibody-drug conjugate trastuzumab deruxtecan has proven to be not only efficient in patients with HER2+ breast cancers (BC), but also in those patients with so-called HER2-low BC. HER2-low tumors are well described in the general BC population, but not in patients with invasive lobular carcinoma (ILC). Here, we aimed at analyzing the association of HER2-low with clinicopathological features and survival outcomes in patients with early-stage pure ILC.</p><p><strong>Methods: </strong>A multicentric retrospective cohort of patients diagnosed with stage I-III estrogen receptor positive (ER+) HER2 negative (HER2-) ILC between 01/01/2000 and 12/31/2020 was assembled. HER2- disease was categorized further by immunohistochemical (IHC) score into HER2 0, HER2 1+ and HER2 2+ following time appropriate ASCO/CAP guidelines from 2007 onward and by local guidelines prior to 2007. The association of HER2-low (HER2 1+ and 2+) with clinicopathological variables was assessed using multinomial logistic regression. Survival analyses were performed to evaluate the association of HER2-low with disease-free (DFS), distant recurrence-free (DRFS) and overall survival (OS).</p><p><strong>Results: </strong>The data of 2098 patients with ER+ HER2- ILC was collected of which 1103 (52.6%) had a HER2-low tumor. Of these 716 (34.1%) had an IHC score of HER2 1+ and 387 (18.4%) of HER2 2+. In multivariable analysis, both tumor size of ≥ 2cm (OR: 1.37; 95%CI 1.01 - 1.87; p-value 0.042) and multifocality (OR: 1.55; 95%CI 1.11 - 2.15; p-value 0.009) were associated with HER2-low. HER2-low was associated with worse DFS (HR: 1.32; 95%CI 1.06 - 1.66; p-value 0.015) and OS (HR: 1.42; 95%CI 1.12 - 1.81; p-value 0.004) as compared to HER2 0. No association of HER2-low with DRFS was observed.</p><p><strong>Conclusions: </strong>HER2-low is present in more than half of the patients with early ER+ HER2- pure ILCs and is associated with larger tumor size and multifocality. HER2-low is associated with a worse DFS and OS as compared to HER2 0.</p>","PeriodicalId":49227,"journal":{"name":"Breast Cancer Research","volume":"27 1","pages":"106"},"PeriodicalIF":5.6000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166569/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of HER2-low with clinicopathological features in patients with early invasive lobular breast cancer: an international multicentric study.\",\"authors\":\"Karen Van Baelen, Ha-Linh Nguyen, François Richard, Gitte Zels, Maria Margarete Karsten, Guilherme Nader-Marta, Peter Vermeulen, Luc Dirix, Adam David Dordevic, Evandro de Azambuja, Denis Larsimont, Marion Maetens, Elia Biganzoli, Hans Wildiers, Ann Smeets, Ines Nevelsteen, Patrick Neven, Giuseppe Floris, Christine Desmedt\",\"doi\":\"10.1186/s13058-025-02058-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The antibody-drug conjugate trastuzumab deruxtecan has proven to be not only efficient in patients with HER2+ breast cancers (BC), but also in those patients with so-called HER2-low BC. HER2-low tumors are well described in the general BC population, but not in patients with invasive lobular carcinoma (ILC). Here, we aimed at analyzing the association of HER2-low with clinicopathological features and survival outcomes in patients with early-stage pure ILC.</p><p><strong>Methods: </strong>A multicentric retrospective cohort of patients diagnosed with stage I-III estrogen receptor positive (ER+) HER2 negative (HER2-) ILC between 01/01/2000 and 12/31/2020 was assembled. HER2- disease was categorized further by immunohistochemical (IHC) score into HER2 0, HER2 1+ and HER2 2+ following time appropriate ASCO/CAP guidelines from 2007 onward and by local guidelines prior to 2007. The association of HER2-low (HER2 1+ and 2+) with clinicopathological variables was assessed using multinomial logistic regression. Survival analyses were performed to evaluate the association of HER2-low with disease-free (DFS), distant recurrence-free (DRFS) and overall survival (OS).</p><p><strong>Results: </strong>The data of 2098 patients with ER+ HER2- ILC was collected of which 1103 (52.6%) had a HER2-low tumor. Of these 716 (34.1%) had an IHC score of HER2 1+ and 387 (18.4%) of HER2 2+. In multivariable analysis, both tumor size of ≥ 2cm (OR: 1.37; 95%CI 1.01 - 1.87; p-value 0.042) and multifocality (OR: 1.55; 95%CI 1.11 - 2.15; p-value 0.009) were associated with HER2-low. HER2-low was associated with worse DFS (HR: 1.32; 95%CI 1.06 - 1.66; p-value 0.015) and OS (HR: 1.42; 95%CI 1.12 - 1.81; p-value 0.004) as compared to HER2 0. No association of HER2-low with DRFS was observed.</p><p><strong>Conclusions: </strong>HER2-low is present in more than half of the patients with early ER+ HER2- pure ILCs and is associated with larger tumor size and multifocality. HER2-low is associated with a worse DFS and OS as compared to HER2 0.</p>\",\"PeriodicalId\":49227,\"journal\":{\"name\":\"Breast Cancer Research\",\"volume\":\"27 1\",\"pages\":\"106\"},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166569/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast Cancer Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13058-025-02058-x\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Cancer Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13058-025-02058-x","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Association of HER2-low with clinicopathological features in patients with early invasive lobular breast cancer: an international multicentric study.
Purpose: The antibody-drug conjugate trastuzumab deruxtecan has proven to be not only efficient in patients with HER2+ breast cancers (BC), but also in those patients with so-called HER2-low BC. HER2-low tumors are well described in the general BC population, but not in patients with invasive lobular carcinoma (ILC). Here, we aimed at analyzing the association of HER2-low with clinicopathological features and survival outcomes in patients with early-stage pure ILC.
Methods: A multicentric retrospective cohort of patients diagnosed with stage I-III estrogen receptor positive (ER+) HER2 negative (HER2-) ILC between 01/01/2000 and 12/31/2020 was assembled. HER2- disease was categorized further by immunohistochemical (IHC) score into HER2 0, HER2 1+ and HER2 2+ following time appropriate ASCO/CAP guidelines from 2007 onward and by local guidelines prior to 2007. The association of HER2-low (HER2 1+ and 2+) with clinicopathological variables was assessed using multinomial logistic regression. Survival analyses were performed to evaluate the association of HER2-low with disease-free (DFS), distant recurrence-free (DRFS) and overall survival (OS).
Results: The data of 2098 patients with ER+ HER2- ILC was collected of which 1103 (52.6%) had a HER2-low tumor. Of these 716 (34.1%) had an IHC score of HER2 1+ and 387 (18.4%) of HER2 2+. In multivariable analysis, both tumor size of ≥ 2cm (OR: 1.37; 95%CI 1.01 - 1.87; p-value 0.042) and multifocality (OR: 1.55; 95%CI 1.11 - 2.15; p-value 0.009) were associated with HER2-low. HER2-low was associated with worse DFS (HR: 1.32; 95%CI 1.06 - 1.66; p-value 0.015) and OS (HR: 1.42; 95%CI 1.12 - 1.81; p-value 0.004) as compared to HER2 0. No association of HER2-low with DRFS was observed.
Conclusions: HER2-low is present in more than half of the patients with early ER+ HER2- pure ILCs and is associated with larger tumor size and multifocality. HER2-low is associated with a worse DFS and OS as compared to HER2 0.
期刊介绍:
Breast Cancer Research, an international, peer-reviewed online journal, publishes original research, reviews, editorials, and reports. It features open-access research articles of exceptional interest across all areas of biology and medicine relevant to breast cancer. This includes normal mammary gland biology, with a special emphasis on the genetic, biochemical, and cellular basis of breast cancer. In addition to basic research, the journal covers preclinical, translational, and clinical studies with a biological basis, including Phase I and Phase II trials.