Abstract
Background
HER2-low expression in breast cancer has received increasing attention as a target for novel antibody–drug conjugates (ADCs). The purpose of this study was to investigate the impact of HER2-low status on survival outcomes in patients with HER2-negative early breast cancer.
Methods
Medical records of patients with HER2-negative non-metastatic breast cancer who were treated at our institution from January 2008 and June 2019 were retrospectively reviewed. The main outcome measurements of our study were overall survival (OS) and disease-free survival (DFS), which were compared between the HER2-low and HER2-0 groups stratified by hormone receptor (HR) status.
Results
A total of 2605 HER2-negative cases were identified, of which 1418 (54.4%) had HER2-low and 1187 (45.6%) had HER2-0 disease. The proportion of HER2-low tumors was significantly higher in HR-positive tumors than in HR-negative tumors. No significant difference was observed in DFS and OS between the HER2-low and HER2-0 groups in univariate analyses, regardless of HR status. Multivariate analysis of the Cox proportional hazard regression model revealed that HER2-low was independently associated with improved OS in patients with HR-negative disease (HR 0.32, 95% CI 0.13–0.80, p = 0.015).
Conclusion
Our findings demonstrate that the prognostic impact of low HER2 expression varies according to HR status, with slightly favorable outcomes among HER2-low tumors in patients with HR-negative disease.
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Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We thank the Department of Pathology, Zhejiang University Medical School Affiliated Sir Run Run Shaw Hospital for providing us with the data of tissue.
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The authors declare that no funds, Grants, or other support were received during the preparation of this manuscript.
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All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by BX, JS. The first draft of the manuscript was written by BX. LW reviewed and revised the manuscript. All authors read and approved the final manuscript.
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The authors have no relevant financial or non-financial interests to disclose.
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The data were all anonymous, and this study was approved by the ethics committee of the Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (ethics number: 2022-0360), with an exemption for patient consent.
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Xu, B., Shen, J., Shen, J. et al. Prognostic impact of HER2-low expression in HER2-negative breast cancer under different hormone receptor status. Int J Clin Oncol 28, 543–549 (2023). https://doi.org/10.1007/s10147-023-02303-3
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DOI: https://doi.org/10.1007/s10147-023-02303-3