Comparison of clinicopathological characteristics and response to neoadjuvant chemotherapy between HER2-low and HER2-zero breast cancer

Shuling Zhou; Ting Liu; Xiaying Kuang; Tiantian Zhen; Huijuan Shi; Ying Lin; Nan Shao

doi:10.1016/j.breast.2022.12.006

Comparison of clinicopathological characteristics and response to neoadjuvant chemotherapy between HER2-low and HER2-zero breast cancer

Breast. 2023 Feb:67:1-7. doi: 10.1016/j.breast.2022.12.006. Epub 2022 Dec 14.

Authors

Shuling Zhou¹, Ting Liu², Xiaying Kuang³, Tiantian Zhen⁴, Huijuan Shi⁵, Ying Lin⁶, Nan Shao⁷

Affiliations

¹ Department of Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China; Laboratory of Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: zhoushling@mail2.sysu.edu.cn.
² Department of Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: liut65@mail2.sysu.edu.cn.
³ Department of Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: kuangxy5@mail.sysu.edu.cn.
⁴ Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: zhentt3@mail.sysu.edu.cn.
⁵ Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: shihj@mail.sysu.edu.cn.
⁶ Department of Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: linying3@mail.sysu.edu.cn.
⁷ Department of Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 510080, China. Electronic address: shaon@mail.sysu.edu.cn.

Abstract

Novel anti-HER2 antibody-drug conjugates trastuzumab deruxtecan (DS-8201a) showed its effect in previously-treated HER2-low metastatic breast cancer, suggesting a promising future in HER2-low breast cancer. We retrospectively reviewed the clinicopathological data of 325 patients with stage I-III HER2 negative breast cancer who received neoadjuvant chemotherapy in the First Affiliated Hospital of Sun Yat-sen University from January 2016 to June 2021. In general, 91 patients (28.0%) were HER2-zero, and 234 patients (72.0%) were HER2-low. The pathological complete response (pCR) rate of the entire cohort was 17.3%. The pCR rate was 16.7% in HER2-low group, and 18.9% in HER2-zero group, showing no significant difference. Patients with HER2-low tumors had significantly longer overall survival (OS) than patients with HER2-zero tumors. ER status was the affecting factor of OS in HER2-low patients in both univariate and multivariate analysis. In conclusion, evidence for HER2-low BC as a distinct entity is insufficient, and more efforts are needed to standardize the scoring of HER2-low breast cancer.

Keywords: HER2-low breast cancer; Neoadjuvant chemotherapy; Pathological complete response; Survival.

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Breast Neoplasms* / pathology
Female
Humans
Neoadjuvant Therapy
Receptor, ErbB-2 / analysis
Retrospective Studies
Trastuzumab / therapeutic use
Treatment Outcome

Substances

Receptor, ErbB-2
Trastuzumab