ArticleTherapeutic advances in medical oncology2026
Dynamics of HER2 status following neoadjuvant systemic therapy in breast cancer: a large single-center cohort analysis.
Article in Therapeutic advances in medical oncology, 2026. 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
Background: Receptor conversion, including changes in human epidermal growth factor receptor 2 (HER2) expression, has been reported after neoadjuvant therapy (NAT), but determinants of HER2 changes between baseline biopsy and residual disease remain incompletely understood. Objective: To evaluate the rate of HER2 status conversion after NAT and to identify factors associated with these changes in the context of contemporary treatment standards. Design: Retrospective analysis of patients with breast cancer (BC) treated with NAT followed by surgery between January 2019 and June 2024. Methods: BC was classified as HER2-0, HER2-low, or HER2-positive. HER2 expression before and after NAT was compared. Probabilities of HER2 subtype conversion were estimated, and univariable and multivariable analyses were performed to assess clinicopathological factors associated with HER2 status changes. Results: A total of 736 patients were included in the analysis, with HER2 status conversion observed in 34.2% (252/736) patients. The shift in HER2 expression occurred in 38.5% (94/244) of HER2-0, 27.9% (95/340) of HER2-low, and 41.4% (63/152) of HER2-positive tumors. A decrease in HER2 status was significantly more common than an increase (29.7% vs 18.2%; Conclusion: HER2 status conversion affects about one-third of BCs after NAT, most commonly as downregulation, supporting HER2 reassessment in residual disease to guide post-NAT treatment decisions.
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