Differential impact of hormone receptor status on survival and recurrence for HER2 receptor-positive breast cancers treated with Trastuzumab.
Differential impact of hormone receptor status on survival and recurrence for HER2 receptor-positive breast cancers treated with Trastuzumab.
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DOI：
10.1007/s10549-017-4225-5
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发表时间：
2017-07
影响因子：
3.8
通讯作者：
Kerin MJ
中科院分区：
文献类型：
--
作者：
McGuire A;Kalinina O;Holian E;Curran C;Malone CA;McLaughlin R;Lowery A;Brown JAL;Kerin MJ
激素受体状态对乳腺癌的治疗和生存具有重大影响。然而，激素受体状态对曲妥珠单抗治疗后结果的影响却很少受到关注。本文的目的是探讨曲妥珠单抗治疗 (Trast +ve) 对 Luminal B HER2 或 HER2+(ER−) 乳腺癌亚型的差异影响。根据分子亚型和曲妥珠单抗治疗对 469 例 HER2 受体阳性乳腺癌队列进行分类。使用单变量和多变量分析，按亚型研究曲妥珠单抗治疗对生存、局部复发和远处转移的影响。 Trast +ve Luminal B HER2 患者的 5 年 DFS (p < 0.001) 和 OS (p < 0.001) 显着改善，而 Trast +ve HER2+(ER−) 患者仅 5 年 DFS (p = 0.012) 就有显着改善。仅 Trast +ve Luminal B HER2 癌症显示 LRR 率显着降低 (p < 0.001)。 Trast +ve Luminal B HER2 (p < 0.001) 和 HER2+(ER−) (p = 0.009) 癌症的远处转移率显着降低。有趣的是，Trast +ve Luminal B HER2 癌症的骨转移率降低幅度最大（36.2-6.7%）。对 Trast +ve 患者的多变量分析发现亚型之间的远处转移率没有差异 (p = 0.96)。值得注意的是，与 Trast +ve HER2+(ER−) 相比，Trast +ve Luminal B HER2 癌症的 LRR 率较低 (p = 0.018)。 Luminal B HER2 癌症对曲妥珠单抗的反应增强。我们重点介绍曲妥珠单抗治疗如何改变 HER2 受体阳性乳腺癌的自然史，证明在改变激素受体阳性患者的预后方面具有改善的功效。本文的在线版本 (doi:10.1007/s10549-017-4225-5) 包含补充材料，可供授权用户使用。
Hormone receptor status has major implications for treatment and survival of breast cancer. Yet the impact of hormone receptor status on outcome after Trastuzumab has received little attention. The objective here was to explore any differential effects of Trastuzumab treatment (Trast +ve) on Luminal B HER2 or HER2+(ER−) breast cancer subtypes. A cohort of 469 HER2 receptor-positive breast cancers was categorised by molecular subtype and Trastuzumab treatment. Effects of Trastuzumab treatment on survival, locoregional recurrence and distant metastasis were investigated by subtype, using univariate and multivariate analysis. Trast +ve Luminal B HER2 patients had significant improvements in 5-year DFS (p < 0.001) and OS (p < 0.001), while Trast +ve HER2+(ER−) patients had significant improvements in 5-year DFS (p = 0.012) alone. Only Trast +ve Luminal B HER2 cancers displayed a significant reduction in LRR rates (p < 0.001). A significant reduction in distant metastasis rates was seen in Trast +ve Luminal B HER2 (p < 0.001) and HER2+(ER−) (p = 0.009) cancers. Interestingly, bone metastasis rates in Trast +ve Luminal B HER2 cancers demonstrated the greatest reduction (36.2–6.7%). Multivariate analysis of Trast +ve patients found no difference in distant metastasis rates (p = 0.96) between subtypes. Significantly, lower LRR rates were seen in Trast +ve Luminal B HER2 cancers, compared to Trast +ve HER2+(ER−) (p = 0.018). An enhanced response to Trastuzumab was seen in Luminal B HER2 cancers. We highlight how Trastuzumab treatment changed the natural history of the HER2 receptor-positive breast cancer, demonstrating improved efficacy in changing the outcome of hormone receptor-positive patients. The online version of this article (doi:10.1007/s10549-017-4225-5) contains supplementary material, which is available to authorized users.