1. A population-based study on trajectories of HER2 status during neoadjuvant chemotherapy for early breast cancer and metastatic progression.
- Author
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Boman C, Liu X, Eriksson Bergman L, Sun W, Tranchell C, Toli MA, Acs B, Bergh J, Foukakis T, and Matikas A
- Subjects
- Humans, Female, Middle Aged, Sweden epidemiology, Aged, Adult, Neoplasm Metastasis, Prognosis, Cohort Studies, Chemotherapy, Adjuvant, Neoplasm, Residual, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Breast Neoplasms metabolism, Receptor, ErbB-2 metabolism, Neoadjuvant Therapy, Disease Progression
- Abstract
Background: This study aimed to investigate the distribution and changes of HER2 status in untreated tumours, in residual disease and in metastasis, and their long-term prognostic implications., Methods: This is a population-based cohort study of patients treated with neoadjuvant chemotherapy for breast cancer during 2007-2020 in the Stockholm-Gotland region which comprises 25% of the entire Swedish population. Information was extracted from the National Breast Cancer Registry and electronic patient charts to minimize data missingness and misclassification., Results: In total, 2494 patients received neoadjuvant chemotherapy, of which 2309 had available pretreatment HER2 status. Discordance rates were 29.9% between primary and residual disease (kappa = 0.534), 31.2% between primary tumour and metastasis (kappa = 0.512) and 33.3% between residual disease to metastasis (kappa = 0.483). Adjusted survival curves differed between primary HER2 0 and HER2-low disease (p < 0.001), with the former exhibiting an early peak in risk for death which eventually declined below the risk of HER2-low. Across all disease settings, increasing the number of biopsies increased the likelihood of detecting HER2-low status., Conclusion: HER2 status changes during neoadjuvant chemotherapy and metastatic progression, and the long-term behaviours of HER2 0 and HER2-low disease differ, underscoring the need for obtaining tissue biopsies and for extended follow-up in breast cancer studies., (© 2024. The Author(s).)
- Published
- 2024
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