JCO precision oncology · 2026
Real-World Study Assessing Characteristics and Treatment Patterns of Patients With Human Epidermal Growth Factor Receptor 2 Immunohistochemistry 0 and Human Epidermal Growth Factor Receptor 2-Low Stage IV Breast Cancer: A Multicenter Retrospective Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Tan Chia Jie, Willis Connor, Au Trang, Schabath Matthew B, Li Chenghui, Kelley Kristen, Xu Xiaoqing, Park Leah, Lam Clara, Mehta Sandhya, Kwong Jackie, Brixner Diana, Stenehjem David
Аннотация
PURPOSE: To describe and compare patient characteristics, treatment patterns, and survival outcomes of patients with human epidermal growth factor receptor 2 (HER2)-low and HER2 immunohistochemistry 0 (IHC 0) stage IV breast cancer.
METHODS: A retrospective study was conducted across three academic centers in the United States. Adult patients diagnosed with stage IV breast cancer between 1-1-2010 and 12-31-2020 and classified as having either HER2-low (immunohistochemistry 1+/2+ with negative fluorescence in situ hybridization) or HER2 IHC 0 disease were followed through 12-31-2021. Patient characteristics, treatments received, and treatment discontinuation were analyzed and survival analyses were conducted using Kaplan-Meier methods.
RESULTS: Among 501 eligible patients, 385 were classified as HER2-low (76.8%) and 116 as HER2 IHC 0 (23.2%). No statistically significant differences were found for demographic characteristics, but PTEN mutations (11.6% v 0%, P = .02) were more common, while germline BRCA1 mutations (1.9% v 8.6%, P = .04) were less prevalent in the HER2-low subgroup compared with those with HER2 IHC 0 disease. Treatment patterns in both subgroups were largely similar. In the overall cohort, 20%-30% of patients who discontinued treatment did not proceed to a subsequent line of therapy. Median overall survival trended shorter in the HER2 IHC 0 subgroup than the HER2-low subgroup, but 95% confidence intervals overlapped. For both subgroups, progression-free survival (PFS) decreased substantially at 2L and 3L compared with previous line of therapy.
CONCLUSION: Patient characteristics were similar between HER2-low and HER2 IHC 0 subgroups except for some differences in genetic alterations. Deterioration of PFS in later lines of therapy highlights a potential unmet need. Given the high patient attrition, the most effective treatments should be used as early as indicated as some patients may not proceed to subsequent lines of therapy.
METHODS: A retrospective study was conducted across three academic centers in the United States. Adult patients diagnosed with stage IV breast cancer between 1-1-2010 and 12-31-2020 and classified as having either HER2-low (immunohistochemistry 1+/2+ with negative fluorescence in situ hybridization) or HER2 IHC 0 disease were followed through 12-31-2021. Patient characteristics, treatments received, and treatment discontinuation were analyzed and survival analyses were conducted using Kaplan-Meier methods.
RESULTS: Among 501 eligible patients, 385 were classified as HER2-low (76.8%) and 116 as HER2 IHC 0 (23.2%). No statistically significant differences were found for demographic characteristics, but PTEN mutations (11.6% v 0%, P = .02) were more common, while germline BRCA1 mutations (1.9% v 8.6%, P = .04) were less prevalent in the HER2-low subgroup compared with those with HER2 IHC 0 disease. Treatment patterns in both subgroups were largely similar. In the overall cohort, 20%-30% of patients who discontinued treatment did not proceed to a subsequent line of therapy. Median overall survival trended shorter in the HER2 IHC 0 subgroup than the HER2-low subgroup, but 95% confidence intervals overlapped. For both subgroups, progression-free survival (PFS) decreased substantially at 2L and 3L compared with previous line of therapy.
CONCLUSION: Patient characteristics were similar between HER2-low and HER2 IHC 0 subgroups except for some differences in genetic alterations. Deterioration of PFS in later lines of therapy highlights a potential unmet need. Given the high patient attrition, the most effective treatments should be used as early as indicated as some patients may not proceed to subsequent lines of therapy.