ArticleNPJ breast cancer2021
Evolution of HER2-low expression from primary to recurrent breast cancer.
Article in NPJ breast cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 144 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
144 citing papers in PubMed, 3 syntheses or guidelines pooled it, 217 citations in OpenAlex.
- Survival disparities in HER2-low versus HER2-positive breast cancer: a systematic review of progression-free survival and overall survival.Frontiers in oncology · 2026Pooled it
- The association between HER2-low status and survival in patients with metastatic breast cancer treated with Cyclin-dependent kinases 4 and 6 inhibitors: a systematic review and meta-analysis.Breast cancer research and treatment · 2024Pooled it
- Clinicopathologic characteristics and prognostic significance of HER2-low expression in patients with early breast cancer: A systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Genomic Characterization and Prognostic Significance of Human Epidermal Growth Factor Receptor 2-Low, Hormone Receptor-Positive, Early Breast Cancers From the BIG 1-98 and SOFT Clinical Trials.JCO precision oncology · 2025Trial
- Phase II Trial Assessing the Repeatability and Tumor Uptake of [Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2024Trial
- A modular framework for antibody-drug conjugate biomarkers.Nature reviews. Clinical oncology · 2026Review
- Tumor-Aware Unsupervised Digital HER2 Immunohistochemistry via Dual Contrastive Learning.Biosensors · 2026Article
- HER2-low metastatic breast cancers: clinic-pathological characteristics, metastatic sites, and survival impact on biomarker discordance.Virchows Archiv : an international journal of pathology · 2026Article
- Evaluation of HER2 status in endometrial carcinoma using endometrial, gastric, and breast cancer criteria: focus on HER2-low.Journal of gynecologic oncology · 2026Article
- Artificial Intelligence (AI)-Assisted Human Epidermal Growth Factor Receptor 2 (HER2) Scoring in Breast Cancer: Diagnostic Agreement and Understanding Discordance.Laboratory investigation; a journal of technical methods and pathology · 2026Article
- Emerging role of human epidermal growth factor 2-low status in the prognosis and management of triple-negative breast cancer: a narrative review.Translational cancer research · 2026Review
- Trastuzumab Deruxtecan for HER2-Low Metastatic Breast Cancer: Practical Considerations for Medical Oncologists and Pathologists in Australia.Asia-Pacific journal of clinical oncology · 2026Review
- Article
- Multi-institutional assessment of HER2 immunohistochemistry in gastric and esophagogastric junction cancer.iScience · 2026Article
- Clinicopathological characteristics and prognostic significance of HER2 status evaluation in patients with urothelial carcinoma: a retrospective single-center experience in China.Virchows Archiv : an international journal of pathology · 2026Article
- Mechanisms of Resistance and Synergy: The Role of Tumor Microenvironment in HER2-Low Breast Cancer Therapy.Pharmaceuticals (Basel, Switzerland) · 2026Review
- AI-enhanced precision: boosting pathologist confidence in HER2 ultra-low diagnosis through intelligent re-screening.Breast cancer research : BCR · 2026Article
- Quantitative HER2 tissue and plasma profiling predicts the activity of trastuzumab deruxtecan for breast cancer.NPJ precision oncology · 2026Article
- Heterogeneity of Hormone Receptors and HER2 in Breast Cancer Cutaneous Metastases: An Institutional Experience.International journal of molecular sciences · 2026Article
- High accuracy in detecting HER2-low status in FNA of primary and metastatic breast cancer.Cancer cytopathology · 2026Article
84 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
About a half of HER2-negative breast cancer (BC) show HER2-low expression that can be targeted by new antibody-drug conjugates. The main aim of this study is to describe the evolution of HER2 expression from primary BC to relapse by including HER2-low category in both primary and recurrent BC samples. Patients with matched primary and relapse BC samples were included. HER2 was evaluated according to ASCO/CAP recommendations in place at the time of diagnosis. A cutoff of >10% cells staining for HER2-positivity was applied. HER2-negative cases were sub-classified as HER2-low (IHC = 1 + /2+ and ISH not amplified), or HER2-0 (IHC-0). 547 patients were included. The proportion of HER2-low cases was 34.2% on the primary tumor and 37.3% on the relapse samples. Among HER2-negative cases, HER2-low status was more frequent in HR-positive vs triple-negative tumors (47.3% vs 35.4% on primary tumor samples, 53.8% vs 36.2% on relapse samples). The overall rate of HER2 discordance was 38.0%, mostly represented by HER2-0 switching to HER2-low (15%) and HER2-low switching to HER2-0 (14%). Among patients with a primary HER2-negative tumor, the rate of HER2 discordance was higher in HR-positive/HER2-negative vs triple-negative cases (45.5% vs 36.7% p = 0.170). This difference was mostly driven by cases switching from HER2-0 to HER2-low. HER2-low expression is highly unstable during disease evolution. Relapse biopsy in case of a primary HER2-0 tumor may open new therapeutic opportunities in a relevant proportion of patients.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.