ArticleJournal of the National Cancer Institute2024
Metastatic site patterns by intrinsic subtype and HER2DX in early HER2-positive breast cancer.
Article in Journal of the National Cancer Institute, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- HER2DX in older patients with HER2-positive early breast cancer: extended follow-up from the RESPECT trial of trastuzumab ± chemotherapy.Nature communications · 2025Trial
- Deep-learning-enabled multi-omics analyses for prediction of future metastasis in cancer.Nature communications · 2026Article
- Evaluating distant recurrence-free survival and location of metastasis in HER2+ breast cancer by ER status.International journal of cancer · 2026Article
- Comparative effectiveness and safety of adjuvant trastuzumab plus pertuzumab versus trastuzumab emtansine in HER2-positive breast cancer with residual disease after neoadjuvant therapy: a real-world retrospective study.Frontiers in oncology · 2026Article
- Metastatic Recurrence of Breast Cancer by Stage and Molecular Profile: A Population-Based Study Among Italian Women.Cancer medicine · 2026Article
- The Roles of MicroRNAs, Oncogenes, and Tumor Suppressor Gene Molecular Subtypes of Breast Cancer: Therapeutic Potential of Pharmaceutical and Natural Products.International journal of breast cancer · 2026Review
- Prognostic value of residual disease (RD) biology and gene expression changes during the neoadjuvant treatment in patients with HER2-positive early breast cancer (EBC).Annals of oncology : official journal of the European Society for Medical Oncology · 2025Article
- Application and challenge of HER2DX genomic assay in HER2+ breast cancer treatment.American journal of cancer research · 2024Review
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEven with contemporary treatment strategies, more than 10% of HER2-positive early stage breast cancer patients may experience distant metastasis as first event during follow-up. Tools for predicting unique patterns of metastatic spread are needed to plan personalized surveillance. We evaluated how molecular heterogeneity affects the pattern of distant relapse in HER2-positive breast cancer.
methodsA total of 677 HER2-positive stage I-III breast cancer patients from ShortHER trial, Cher-LOB trial, and 2 institutional cohorts were included. PAM50 molecular subtypes and research-based HER2DX scores were evaluated. The cumulative incidence of distant relapse as the first event (any site and site specific) was evaluated using competing risk analysis. Median follow-up was 8.4 years. Tests of statistical significance are 2-sided.
resultsStage III and high HER2DX risk score identified patients at the highest risk of distant relapse as first event (10-year incidence 24.5% and 19.7%, respectively). Intrinsic molecular subtypes were associated with specific patterns of metastatic spread: compared with other subtypes, HER2-enriched tumors were more prone to develop brain metastases (10-year incidence 3.8% vs 0.6%, P = .005), basal-like tumors were associated with an increased risk of lung metastases (10-year incidence 11.1% vs 2.6%, P = .001), and luminal tumors developed more frequently bone-only metastases (10-year incidence 5.1% vs 2.0%, P = .042). When added to stage or HER2DX risk score in competing risk regression models, intrinsic subtype maintained an independent association with site-specific metastases.
conclusionsThe integration of intrinsic molecular subtypes with stage or HER2DX risk score predicts site-specific metastatic risk in HER2-positive breast cancer, with potential implications for personalized surveillance and clinical trials aimed at preventing site-specific recurrence.
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