The clinical value of HER-2 overexpression and PIK3CA mutations in the older breast cancer population: a FOCUS study analysis.
The clinical value of HER-2 overexpression and PIK3CA mutations in the older breast cancer population: a FOCUS study analysis.
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DOI：
10.1007/s10549-016-3734-y
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发表时间：
2016-04
影响因子：
3.8
通讯作者：
Liefers GJ
中科院分区：
文献类型：
--
作者：
Engels CC;Kiderlen M;Bastiaannet E;van Eijk R;Mooyaart A;Smit VT;de Craen AJ;Kuppen PJ;Kroep JR;van de Velde CJ;Liefers GJ
证实公认的预后标志物在老年乳腺癌患者中的作用的研究很少。本研究的目的是评估HER-2过表达和PIK3CA突变在老年乳腺癌患者中的预后价值。年龄在65岁或以上的女性乳腺癌患者，在1997年至2004年期间在荷兰的一个地理区域被诊断为侵袭性，非转移性肿瘤和肿瘤材料，包括在研究中。主要终点为无复发期，次要终点为相对生存期。决定因素是免疫化学HER-2评分（0/1+，2+或3+）和PIK3CA作为二元测量。共纳入1698例患者，其中103例HER-2评分为3+。HER-2过表达与较高的复发风险（5年复发风险34% vs. 12%，校正p = 0.005）和较差的相对生存率（HER-2阴性的10年相对生存率48% vs. 84%, p = 0.004）相关。PIK3CA突变对预后无显著影响。我们发现，在老年乳腺癌患者中，HER-2过表达与较差的预后显著相关，但PIK3CA突变对预后没有影响。这些结果表明HER-2过表达的老年乳腺癌患者可能受益于额外的靶向抗HER-2治疗。本文的在线版本（doi:10.1007/s10549-016-3734-y）包含补充材料，仅供授权用户使用。
Studies to confirm the effect of acknowledged prognostic markers in older breast cancer patients are scarce. The aim of this study was to evaluate the prognostic value of HER-2 overexpression and PIK3CA mutations in older breast cancer patients. Female breast cancer patients aged 65 years or older, diagnosed between 1997 and 2004 in a geographical region in The Netherlands, with an invasive, non-metastatic tumour and tumour material available, were included in the study. The primary endpoint was relapse-free period and secondary endpoint was relative survival. Determinants were immunochemical HER-2 scores (0/1+, 2+ or 3+) and PIK3CA as a binary measure. Overall, 1698 patients were included, and 103 had a HER-2 score of 3+. HER-2 overexpression was associated with a higher recurrence risk (5 years recurrence risk 34 % vs. 12 %, adjusted p = 0.005), and a worse relative survival (10 years relative survival 48 % vs. 84 % for HER-2 negative; p = 0.004). PIK3CA mutations had no significant prognostic effect. We showed, in older breast cancer patients, that HER-2 overexpression was significantly associated with a worse outcome, but PIK3CA mutations had no prognostic effect. These results imply that older patients with HER-2 overexpressing breast cancer might benefit from additional targeted anti-HER-2 therapy. The online version of this article (doi:10.1007/s10549-016-3734-y) contains supplementary material, which is available to authorised users.