Distribution of PD-L1, TROP2 and HER2- "lowness" in early triple-negative breast cancer: an opportunity for treatment de-escalation

Clin Transl Oncol. 2024 May;26(5):1273-1279. doi: 10.1007/s12094-023-03329-9. Epub 2023 Oct 18.

Abstract

Background: HER2, TROP2 and PD-L1 are novel targets in triple-negative breast cancer (TNBC). The combined expression status of these targets, and whether they can define prognostic subgroups, is currently undefined.

Methods: Immunohistochemistry was used to determine HER2, TROP2 and PD-L1 levels in 459 TNBC cases, that received in the adjuvant/neoadjuvant setting active surveillance, CMF, anthracycline-, anthracycline plus taxane-, or carboplatin-containing regimes.

Results: HER2-low patients with PD-L1 > 1 CPS (double-positive, herein "DP") had a mean PFS of 4768 days (95% CI: 4267-5268) versus 3522 days (95% CI: 3184-3861) for non-DP patients (P = 0.002). Regarding the received adjuvant treatment, DP patients (versus non-DP) receiving anthracyclines plus taxanes exhibited a mean PFS time of 4726 (95% CI: 4022-5430) versus 3302 (95% CI: 2818-3785) days (P = 0.039). Finally, 100% of DP patients that received a carboplatin-based regimen were long-term disease-free.

Conclusions: Early HER2-low, PD-L1-positive TNBC patients have a very good prognosis, particularly if treated with anthracycline/taxane- or carboplatin-containing regimes.

Keywords: Carboplatin; HER2-low; PD-L1; TROP2; Triple-negative breast cancer.

MeSH terms

  • Anthracyclines / therapeutic use
  • Antibiotics, Antineoplastic / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • B7-H1 Antigen
  • Bridged-Ring Compounds*
  • Carboplatin / therapeutic use
  • Humans
  • Neoadjuvant Therapy
  • Taxoids*
  • Triple Negative Breast Neoplasms* / drug therapy
  • Triple Negative Breast Neoplasms* / metabolism

Substances

  • taxane
  • Carboplatin
  • B7-H1 Antigen
  • Anthracyclines
  • Antibiotics, Antineoplastic
  • Bridged-Ring Compounds
  • Taxoids