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Anticipating changes in the HER2 status of breast tumours with disease progression—towards better treatment decisions in the new era of HER2-low breast cancers

Authors :
Anthony Bergeron
Aurélie Bertaut
Françoise Beltjens
Céline Charon-Barra
Alix Amet
Clémentine Jankowski
Isabelle Desmoulins
Sylvain Ladoire
Laurent Arnould
Source :
British Journal of Cancer.
Publication Year :
2023
Publisher :
Springer Science and Business Media LLC, 2023.

Abstract

Background HER2 expression is often negative or low in primary breast cancers (BCs) but its changes with disease progression remain poorly known. We aimed to estimate them between primary and recurrent tumours, and identify predictive factors. Methods We compared the HER2 status, and clinical and pathological characteristics by its evolution category (stable or changed), between all primary BCs and matched recurrences registered in our database in 2000–2020 (n = 512). Results HER2-low tumours were the most prevalent at diagnosis (44.9%), followed by HER2-negative tumours (39.3%). HER2 status significantly changed in 37.3% of recurrences, mainly of HER2-negative and HER2-low tumours. HER2-negative tumours which relapsed as HER2-low significantly more frequently expressed oestrogen receptors (ER) and recurred later than stably HER2-negative tumours. Changed HER2 status in distant metastases correlated with lower proliferation rates and higher ER expression in primary tumours, and among metastases of hormone receptor-positive (HR+) tumours—with weak progesterone receptor (PR) expression in primary tumours. Conclusions HER2 status changes with BC progression, with enrichment of HER2-low tumours in advanced stages. The ER+/PR− status, low proliferation index and time to late recurrence correlated with these changes. These findings highlight the need of retesting recurrences, especially of HR + primary tumours, to identify candidates for new anti-HER2 therapies.

Subjects

Subjects :
Cancer Research
Oncology

Details

ISSN :
15321827 and 00070920
Database :
OpenAIRE
Journal :
British Journal of Cancer
Accession number :
edsair.doi...........fd6704126c57a278dfa7fbc26644fe41
Full Text :
https://doi.org/10.1038/s41416-023-02287-x