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. 2024 Jul 23;14(1):16899.
doi: 10.1038/s41598-024-67795-z.

Efficacy and prognosis of HER2-Low and HER2-Zero in triple-negative breast cancer after neoadjuvant chemotherapy

Zhendong Shi  1   2   3   4 , Yingxue Liu  1   2   3   4 , Xuan Fang  1   2   3   4 , Xu Liu  1   2   3   4 , Jie Meng  1   2   3   4 , Jin Zhang  5   6   7   8
Affiliations

Efficacy and prognosis of HER2-Low and HER2-Zero in triple-negative breast cancer after neoadjuvant chemotherapy

Zhendong Shi et al. Sci Rep. .

Abstract

Mounting evidence showed that HER2-Low breast cancer patients could benefit from the novel anti-HER2 antibody-drug conjugates (ADCs) treatment, which pointed the way towards better therapy for HER2-Low patients. The purpose of this study was to describe the clinicopathological features, along with chemotherapeutic effects and survival outcomes of HER2-Low and HER2-Zero in TNBC who received neoadjuvant chemotherapy (NACT). We retrospectively evaluated 638 triple-negative breast cancer patients who were treated with neoadjuvant chemotherapy between August 2014 and August 2022. Pathologic complete response (pCR) and survival outcomes were analyzed in HER2-Low cohort, HER2-Zero cohort and the overall patients, respectively. In the entire cohort, 342 (53.6%) patients were HER2-Low and 296 (46.4%) patients were HER2-Zero. No significant difference was found between HER2-Low and HER2-Zero patients based on all the clinical-pathological characteristics. 143 cases (22.4%) achieved pCR after NACT in the overall TNBC patients. The pCR rate of the HER2-Low patients and the HER2-Zero patients was 21.3% and 23.6%, respectively, exhibiting no statistical difference (p = 0.487). The survival of pCR group after NACT significantly improved compared to non-pCR group either in HER2-Low patients or in HER2-Zero patients. Although we found that patients with HER2-Low had longer DFS than patients with HER2-Zero, there was no considerable difference (p = 0.068). However, HER2-Low patients had a dramatically longer OS than HER2-Zero patients (p = 0.012). The data from present study confirmed the clinical importance of HER2-Low expression in TNBC. Further effort is needed to determine whether HER2-Low could be a more favorable prognostic marker for individual treatment.

Keywords: Disease free survival; HER2-Low; Neoadjuvant chemotherapy; Overall survival; Pathologic complete response; Triple-negative breast cancer.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PCR rate in overall patients, HER2-Low group and HER2-Zero group (A). Forest plots for multivariable logistic regression analysis of pCR rates for HER2-low group (B), HER2-Zero group (C) and the overall patients (D).
Figure 2
Figure 2
Kaplan–Meier survival analysis for DFS and OS between pCR and non-pCR in HER2-Low group (A,B), HER-2 Zero group (C,D) and overall patients (E,F).
Figure 3
Figure 3
Kaplan–Meier survival analysis for DFS (A) and OS (B) between HER2-Low and HER-Zero group.
See this image and copyright information in PMC

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