Dataset Information

Prognostic value of HER2 status on circulating tumor cells in advanced-stage breast cancer patients with HER2-negative tumors.

ABSTRACT:

Purpose

Discordance between HER2 expression in tumor tissue (tHER2) and HER2 status on circulating tumor cells (cHER2) has been reported. It remains largely underexplored whether patients with tHER2^-/cHER2⁺ can benefit from anti-HER2 targeted therapies.

Methods

cHER2 status was determined in 105 advanced-stage patients with tHER2^- breast tumors. Association between cHER2 status and progression-free survival (PFS) was analyzed by univariate and multivariate Cox models and survival differences were compared by Kaplan-Meier method.

Results

Compared to the patients with low-risk cHER2 (cHER2⁺ < 2), those with high-risk cHER2 (cHER2⁺ ≥ 2) had shorter survival time and an increased risk for disease progression (hazard ratio [HR] 2.16, 95% confidence interval [CI] 1.20-3.88, P = 0.010). Among the patients with high-risk cHER2, those who received anti-HER2 targeted therapies had improved PFS compared with those who did not (HR 0.30, 95% CI 0.10-0.92, P = 0.035). In comparison, anti-HER2 targeted therapy did not affect PFS among those with low-risk cHER2 (HR 0.70, 95% CI 0.36-1.38, P = 0.306). Similar results were obtained after adjusting covariates. A longitudinal analysis of 67 patients with cHER2 detected during follow-ups found that those whose cHER2 status changed from high-risk at baseline to low-risk at first follow-up exhibited a significantly improved survival compared to those whose cHER2 remained high-risk (median PFS: 11.7 weeks vs. 2.0 weeks, log-rank P = 0.001).

Conclusion

In advanced-stage breast cancer patients with tHER2^- tumors, cHER2 status has the potential to guide the use of anti-HER2 targeted therapy in patients with high-risk cHER2.

SUBMITTER: Wang C

PROVIDER: S-EPMC7299127 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Prognostic value of HER2 status on circulating tumor cells in advanced-stage breast cancer patients with HER2-negative tumors.

Wang Chun C Mu Zhaomei Z Ye Zhong Z Zhang Zhenchao Z Abu-Khalaf Maysa M MM Silver Daniel P DP Palazzo Juan P JP Jagannathan Geetha G Fellin Frederick M FM Bhattacharya Saveri S Jaslow Rebecca J RJ Tsangaris Theodore N TN Berger Adam A Neupane Manish M Cescon Terrence P TP Lopez AnaMaria A Yao Kaelan K Chong Weelic W Lu Brian B Myers Ronald E RE Hou Lifang L Wei Qiang Q Li Bingshan B Cristofanilli Massimo M Yang Hushan H

Breast cancer research and treatment 20200504 3

<h4>Purpose</h4>Discordance between HER2 expression in tumor tissue (tHER2) and HER2 status on circulating tumor cells (cHER2) has been reported. It remains largely underexplored whether patients with tHER2<sup>-</sup>/cHER2<sup>+</sup> can benefit from anti-HER2 targeted therapies.<h4>Methods</h4>cHER2 status was determined in 105 advanced-stage patients with tHER2<sup>-</sup> breast tumors. Association between cHER2 status and progression-free survival (PFS) was analyzed by univariate and mult ...[more]

PMID: 32367460

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Project description:PurposeHuman epidermal growth factor receptor 2 (HER2)-directed treatments improve outcomes for patients with HER2-positive metastatic breast cancer (MBC). Current identification of patients with HER2-positive disease relies on tumor tissue testing, which can be inaccurate because of tumor heterogeneity or tumor evolution. Circulating tumor cells (CTCs) are often present in patients with cancer. We hypothesized that HER2 assessment of CTCs in patients with HER2-negative breast cancer could identify a subset of patients with HER2-positive CTCs who could benefit from HER2-directed treatments.MethodsThis was a single-arm, two-stage, phase II trial. Patients with HER2-negative progressive MBC with HER2-positive CTC (defined as HER2/CEP17 ratio ≥ 2.0 by fluorescence in situ hybridization), ≥ 1 prior chemotherapy regimen for MBC, and no prior vinorelbine received trastuzumab in combination with vinorelbine on days 1, 8, and 15 of a 21-day cycle. The primary end point was objective response rate.ResultsFrom January 2013 to June 2014, we prospectively screened CTCs from patients with HER2-negative MBC. CTCs were detected in 201 of 311 patients (65%). The median number of CTCs was 10 (interquartile range, 3-57). Sixty-nine of 311 patients (22%) had HER2+ CTCs, with a median of three HER2+ CTCs (range 1-21). Twenty patients with HER2+ CTCs were treated on study. At data cutoff (January 13, 2017), no patients remained on study therapy. The objective response rate was 5% (95% CI, 0.1 to 24.9), with one of 20 patients experiencing a partial response. The clinical benefit rate was 20.0% (1 partial response and 3 stable diseases > 24 weeks, 95% CI, 5.7% to 43.7%). The median progression-free survival was 2.7 months.ConclusionCTC analysis of patients with HER2-negative MBC identifies a subset with HER2-amplified CTCs. However, clinical activity of an HER2-directed regimen in this population was low. The functional significance of HER2-positive CTCs remains uncertain.

Dataset Information

Prognostic value of HER2 status on circulating tumor cells in advanced-stage breast cancer patients with HER2-negative tumors.

Purpose

Methods

Results

Conclusion

Publications

Prognostic value of HER2 status on circulating tumor cells in advanced-stage breast cancer patients with HER2-negative tumors.

Similar Datasets

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