转移性乳腺癌患者治疗过程中的受体不一致：来自SONABRE注册的结果。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-07-30 DOI:10.1016/j.clbc.2025.07.020

Karlijn E.P.E. Hermans , Sandra M.E. Geurts , Franchette Van den Berkmortel , Jolien Tol , Joan B. Heijns , Marcus W. Dercksen , Birgit E.P.J. Vriens , Kirsten N.A. Aaldering , Manon J.A.E. Pepels , Natascha A.J.B. Peters , Linda van de Winkel , Eline Boon , Nathalie Teeuwen , Maartje A.C.E. van Kats , Vivianne C.G. Tjan-Heijnen

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引用次数: 0

摘要

目的：目的是评估转移性乳腺癌（mBC）病程中两次活检的相关因素，并评估雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2 （HER2）的不一致率。方法：从SONABRE登记处（NCT-03577197）检索2007年至2020年间10家荷兰医院诊断为mBC的患者。如果患者在其mBC病程的不同时间点进行了至少2次活检，则确定患者。最后一次随访是在2023年9月。使用竞争风险分析和亚分布风险比（sHR）研究了与第二次活检相关的频率和因素。使用比值比（OR）进行逻辑回归分析不一致率和与受体亚型不一致相关的因素。结果：在4470例mBC患者中，65%的患者在mBC过程中进行了1次活检，10%的患者进行了2次活检。与参考分类相比，2次活检与年龄（sHR: 0.61）、合并症（sHR: 0.76）、WHO表现评分（sHR: 0.30≥2）、初始TN亚型（sHR: 0.67）和初始转移部位（仅软组织sHR: 3.68）相关。与第二次活检相比，患者的总体受体亚型不一致性为23%。只有HR+/HER2+状态与受体亚型不一致有关（OR: 6.45）。结论：只有少数mBC患者在其病程中进行了第二次活检。然而，受体亚型异质性很常见，特别是在最初患有HR+/HER2+ mBC的患者中。未来的研究需要指导治疗决策，因为异质性可能起作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Receptor Discordance During the Treatment Course of Patients With Metastatic Breast Cancer: Results From the SONABRE Registry

Purpose

The aim was to evaluate factors associated with taking 2 biopsies during the disease course of metastatic breast cancer (mBC) and to assess discordance rates for the oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).

Methods

Patients diagnosed with mBC in ten Dutch hospitals between 2007 and 2020 were retrieved from the SONABRE Registry (NCT-03577197). Patients were identified if they had at least 2 biopsies at different time points during their mBC disease course. Last follow-up was collected in September 2023. Frequencies and factors related to a second biopsy were studied using competing risk analysis with subdistribution hazard ratios (sHR). Discordance rates and factors associated with receptor subtype discordance were analysed using logistic regression using odds ratios (OR).

Results

Of 4,470 patients with mBC, 65% had 1 and 10% 2 biopsies during the course of mBC. Having 2 biopsies for mBC was related to age (sHR: 0.61), comorbidity (sHR: 0.76), WHO performance score (sHR: 0.30 for ≥2), initial TN subtype (sHR: 0.67), and initial metastatic site (sHR: 3.68 for soft tissue only), compared with the reference categories. Patients had an overall receptor subtype discordance of 23% compared to the second biopsy. Only HR+/HER2+ status was related to receptor subtype discordance (OR: 6.45).

Conclusion

Only the minority of patients with mBC underwent a second biopsy during their mBC disease course. Receptor subtype heterogeneity is however frequent, particularly in patients with initially HR+/HER2+ mBC. Future studies are needed to guide treatment decisions as heterogeneity may play a role.

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.