ArticleBMC cancer2025
Genomically determined subtypes and clinicopathological features as predictors of the efficacy of preoperative chemotherapy combined with HER2-targeted therapy for early-stage HER2-positive breast cancer.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNeoadjuvant chemotherapy (NAC) combined with human epidermal growth factor receptor 2 (HER2)-targeted agents is the mainstay of treatment of HER2-positive (HER2 +) breast cancer (BC). We investigated intrinsic subtypes and clinicopathological features as predictors of outcomes of NAC in HER2 + early-stage BC patients.
methodsOf 186 consecutive patients with early-stage HER2 + BC, as determined by immunohistochemistry (IHC) and fluorescence in situ hybridization, who received NAC plus HER2-targeted agents, 167 with an available biopsy specimen were eligible for inclusion. Intrinsic subtypes were determined by MammaPrint and Blueprint (MP/BP). Whole-slide images of HER2 IHC staining were used to evaluate intensity of HER2 staining.
resultsMP/BP subtype was determined for 124 patients: Luminal-A, 17 patients; Luminal-B, 23 patients; HER2, 76 patients; and Basal, 8 patients. Pathological complete response (pCR) rate was significantly higher in HER2 than in non-HER2 cases (p < 0.001). High-intensity (p = 0.001) and BP-determined HER2 intrinsic subtype (p = 0.024) were identified as independent factors for pCR prediction. Neither Luminal subtype was found in IHC estrogen receptor (ER)-negative patients; however, 54.3% of IHC ER-positive patients had HER2 subtype. Five-year distant disease-free survival by MP/BP subtype was Luminal-A, 92.3%; Luminal-B, 81.6%; HER2, 84.0%; and Basal, 80.0%. Of the 23 patients whose subtypes were compared before and after surgery, 10 had a change in subtype.
conclusionsHigh HER2 intensity and HER2 intrinsic subtype could be a means for predicting achievement of pCR. The findings indicate the essential role of MP/BP subtyping in the treatment of HER2 + BC.
trial registrationUMIN000049957.
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