ArticleBreast cancer (Dove Medical Press)2023
Differences in Treatment Outcomes Between Patients with HER2-Low versus HER2-Zero, Hormone Receptor-Positive Advanced-Stage Breast Cancer Treated with Ribociclib.
Article in Breast cancer (Dove Medical Press), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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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.
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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
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Efficacy and Safety of Cyclin-Dependent Kinase 4/6 Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials and Real-World Studies.Targeted oncology · 2025Pooled 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
- On-Treatment NLR Dynamics During CDK4/6 Inhibition Are Associated with Overall Survival in Metastatic Breast Cancer.Cancers · 2026Article
- Interplay between HER2-Low status, hormone receptor expression, and therapeutic response to cyclin-dependent kinase 4/6 inhibitors as first-line treatment in luminal-like metastatic breast cancer: The CYCLHER study.Breast (Edinburgh, Scotland) · 2026Observational
- Impact of HER2-Low Expression on Clinical Outcomes in Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.Journal of clinical medicine · 2026Article
- Factors Affecting the Survival of Metastatic Breast Cancer Patients Treated with CDK 4/6 Inhibitors.Medicina (Kaunas, Lithuania) · 2025Article
- Clinical Outcomes of CDK4/6 Inhibitor Therapy in HR+/HER2- Metastatic Breast Cancer: A Multicenter Comparison of HER2-Low and HER2-Zero Subgroups.The breast journal · 2025Article
- Clinical Outcomes of HER2-Low Versus HER2-Zero in HR-Positive Metastatic Breast Cancer Treated With Endocrine Therapy With or Without CDK4/6 Inhibitors: A Multicenter Retrospective Study.International journal of breast cancer · 2025Article
- Human Epidermal Growth Factor Receptor 2-Low Breast Cancer: Prevalence Rate and Scoring Concordance Among Pathologists.Breast cancer : basic and clinical research · 2025Article
- Time to focus again on matrix metalloproteinases? Results of complex network analysis involving the pathophysiology of HER2-positive breast cancer.Ecancermedicalscience · 2025Article
- Review
- Relationship between HER2-low status and efficacy of CDK4/6 inhibitors in advanced breast cancer: a real-world study.International journal of clinical oncology · 2024Article
- The effects of low HER2 expression on survival in patients with metastatic breast cancer treated with CDK 4/6 inhibitors: a multicenter retrospective study.Breast cancer research and treatment · 2024Article
- Prognosis in HR-positive metastatic breast cancer with HER2-low versus HER2-zero treated with CDK4/6 inhibitor and endocrine therapy: a meta-analysis.Frontiers in oncology · 2024Article
- Serum HER2 Level Predicts Therapeutic Efficacy and Prognosis in Advanced Breast Cancer Patients [Letter].Breast cancer (Dove Medical Press) · 2024Article
- Comprehensive Clinical Characterization of Decade-Long Survivors of Metastatic Breast Cancer.Cancers · 2023Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Metastatic breast cancers (MBC) with no expression of human epidermal growth factor receptor-2 (HER2) are recently classified into two groups; HER2-zero [HER2-immunohistochemistry (IHC) score of 0 (IHC-0)] and HER2-low, defined as those with IHC score of 1+ or 2+ with negative in situ hybridization (ISH) assay. We investigate differences in treatment outcomes between both groups treated with endocrine therapy (ET) and the CDK4/6 inhibitor ribociclib. Methods: Data were retrospectively collected for patients with HR-positive+/HER2-negative MBC who received ribociclib with an aromatase inhibitor (AI) or fulvestrant and were divided into two groups: HER2-zero and HER2-low. Results: A total of 257 patients, median age 48 (22-87) years, all with MBC who were treated with ET and ribociclib were enrolled. One hundred and thirty-seven (53.3%) patients had de novo MBC, and majority (n = 162, 63.0%) received ribociclib as a first-line therapy. In total, 114 (44.4%) patients had HER2-zero (IHC-0), while 143 (55.6%) others had HER2-low disease. The overall response rate (ORR) was 52.0% for the HER2-zero group compared to 39.4% for the HER2-low group, p = 0.005. The median PFS was 22.2 (95% confidence interval [CI], 19.4-NR) months for HER2-zero versus 17.3 (95% CI, 14.1-20.6) months for HER2-low, P = 0.0039. In multivariable analysis, HER2-low expression remained significant determinant of inferior PFS after adjusting for other factors, including the site of metastasis, prior chemotherapy, and the line of treatment. Conclusion: In patients with MBC treated with ET and ribociclib, level of HER2 negativity may affect treatment outcomes; patients with HER2-zero had better response rate and PFS compared to those with HER2-low disease. These findings, if confirmed in larger studies, may help oncologists select patients with HER2-low for better treatment options.
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