Changes in tumor expression of HER2 and hormone receptors status after neoadjuvant chemotherapy in 21 755 patients from the Japanese breast cancer registry
Changes in tumor expression of HER2 and hormone receptors status after neoadjuvant chemotherapy in 21 755 patients from the Japanese breast cancer registry
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DOI：
10.1093/annonc/mdv611
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发表时间：
2016-03-01
影响因子：
50.5
通讯作者：
Tokuda, Y.
中科院分区：
文献类型：
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作者：
Niikura, N.;Tomotaki, A.;Tokuda, Y.
我们研究病理完全缓解率（pCR）和肿瘤表达ER， PgR， HER2不一致在新辅助化疗后使用日本乳腺癌登记数据。从乳腺癌登记处检索了2004年至2013年在800家医院治疗的30多万例乳腺癌病例的记录。在数据清理后，我们纳入了21 755名接受新辅助化疗且无远处转移的患者。pCR定义为新辅助化疗后手术中未发现乳腺浸润性肿瘤。免疫组织化学和/或荧光原位杂交法检测HER2过表达。5.7%的管腔肿瘤（n = 8730）、24.6%的her2阳性肿瘤（n = 4403）和18.9%的三阴性肿瘤（n = 3660）实现了pCR。在her2阳性肿瘤中，31.6%的er阴性肿瘤（n = 2252）、17.0%的er阳性肿瘤（n = 2132）、31.4%接受曲妥珠单抗作为新辅助化疗的患者（n = 2437）和16.2%未接受曲妥珠单抗的患者（n = 1966）实现了pCR。在治疗前her2阳性的2811例患者中，601例（21.4%）在新辅助化疗后出现her2阴性肿瘤，而在治疗前her2阴性肿瘤的9947例患者中，340例（3.4%）在治疗后出现her2阳性肿瘤。在10973例治疗前er阳性肿瘤患者中，499例（4.6%）患者在新辅助化疗后出现er阴性肿瘤，而5607例治疗前er阴性患者中，519例（9.3%）患者在治疗后出现er阳性肿瘤。我们证实，原发性her2阳性乳腺癌患者在接受新辅助治疗后，her2阳性状态的丧失可能发生。我们还证实，在实践中，乳腺癌亚型之间的pCR率差异与临床试验相同。我们的数据强烈支持在新辅助治疗后需要重新检测手术样本的ER、PgR、HER2，以准确确定靶向治疗的合适使用。
We investigate rates of pathologic complete response (pCR) and tumor expression of ER, PgR, HER2 discordance after neoadjuvant chemotherapy using Japanese breast cancer registry data.Records of more than 300 000 breast cancer cases treated at 800 hospitals from 2004 to 2013 were retrieved from the breast cancer registry. After data cleanup, we included 21 755 patients who received neoadjuvant chemotherapy and had no distant metastases. pCR was defined as no invasive tumor in the breast detected during surgery after neoadjuvant chemotherapy. HER2 overexpression was determined immunohistochemically and/or using fluorescencein situ hybridization.pCR was achieved in 5.7% of luminal tumors (n = 8730), 24.6% of HER2-positive tumors (n = 4403), and 18.9% of triple-negative tumors (n = 3660). Among HER2-positive tumors, pCR was achieved in 31.6% of ER-negative tumors (n = 2252), 17.0% of ER-positive ones (n = 2132), 31.4% of patients who received trastuzumab as neoadjuvant chemotherapy (n = 2437), and 16.2% of patients who did not receive trastuzumab (n = 1966). Of the 2811 patients who were HER2-positive before treatment, 601 (21.4%) had HER2-negative tumors after neoadjuvant chemotherapy, whereas 340 (3.4%) of the 9947 patients with HER2-negative tumors before treatment had HER2-positive tumors afterward. Of the 10 973 patients with ER-positive tumors before treatment, 499 (4.6%) had ER-negative tumors after neoadjuvant chemotherapy, whereas 519 (9.3%) of the 5607 patients who were ER-negative before treatment had ER-positive tumors afterward.We confirmed that loss of HER2-positive status can occur after neoadjuvant treatment in patients with primary HER2-positive breast cancer. We also confirmed that in practice, differences in pCR rates between breast cancer subtypes are the same as in clinical trials. Our data strongly support the need for retest ER, PgR, HER2 of surgical sample after neoadjuvant therapy in order to accurately determine appropriate use of targeted therapy.