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Clinical Trial
. 2022 Apr;192(3):563-571.
doi: 10.1007/s10549-021-06432-z. Epub 2022 Feb 4.

Clinical outcomes in patients with triple negative or HER2 positive lobular breast cancer: a single institution experience

Alicia Okines  1 , Tazia Irfan  2 , Bernice Asare  2 , Kabir Mohammed  2 , Peter Osin  2 , Ashutosh Nerurkar  2 , Ian E Smith  2 , Marina Parton  2 , Alistair Ring  3 , Stephen Johnston  2 , Nicholas C Turner  2
Affiliations
Clinical Trial

Clinical outcomes in patients with triple negative or HER2 positive lobular breast cancer: a single institution experience

Alicia Okines et al. Breast Cancer Res Treat. 2022 Apr.

Abstract

Purpose: Invasive lobular carcinomas (ILC) are characterised by loss of the cell adhesion molecule E-cadherin. Approximately 15% of ILC are ER negative at the time of breast cancer diagnosis, or at relapse due to loss of ER expression. Less than 5% of classical ILC but up to 35% of pleomorphic ILC are HER2 positive (HER2+).

Methods: Retrospective analysis of clinic-pathological data from patients with Triple negative (TN) or HER2+ ILC diagnosed 2004-2014 at the Royal Marsden Hospital. The primary endpoint was median overall survival (OS) in patients with metastatic disease. Secondary endpoints included response rate to neo-adjuvant chemotherapy (NAC), median disease-free interval (DFI) and OS for patients with early disease.

Results: Three of 16 patients with early TN ILC and 7/33 with early HER2+ ILC received NAC with pCR rates of 0/3 and 3/5 patients who underwent surgery, respectively. Median DFI was 28.5 months [95% Confidence interval (95%CI) 15-78.8] for TN ILC and not reached (NR) (111.2-NR) for HER2+ early ILC. Five-year OS was 52% (95%CI 23-74%) and 77% (95%CI 58-88%), respectively. Twenty-three patients with advanced TN ILC and 14 patients with advanced HER2+ ILC were identified. Median OS was 18.3 months (95%CI 13.0-32.8 months) and 30.4 months (95%CI 8.8-NR), respectively.

Conclusions: In our institution we report a high relapse rate after treatment for early TN ILC, but median OS from metastatic disease is similar to that expected from TN IDC. Outcomes for patients with advanced HER2+ ILC were less favourable than those expected for IDC, possibly reflecting incomplete exposure to anti-HER2 therapies.

Clinical trial registration: ROLo (ClinicalTrials.gov Identifier: NCT03620643), ROSALINE (ClinicalTrials.gov Identifier: NCT04551495).

Keywords: HER2; Lobular; Triple negative.

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References

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