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01-10-2018 | Clinical trial

Effectiveness of neo-adjuvant systemic therapy with trastuzumab for basal HER2 type breast cancer: results from retrospective cohort study of Japan Breast Cancer Research Group (JBCRG)-C03

Authors: Yasuaki Sagara, Masahiro Takada, Yasuyo Ohi, Shoichiro Ohtani, Sasagu Kurozumi, Kenichi Inoue, Yoshimasa Kosaka, Masaya Hattori, Toshinari Yamashita, Shintaro Takao, Nobuaki Sato, Hiroji Iwata, Masafumi Kurosumi, Masakazu Toi

Published in: Breast Cancer Research and Treatment | Issue 3/2018

Abstract

Purpose

While human epidermal growth factor receptor 2 (HER2) target therapies have significantly improved the prognosis of patients with HER2-enriched breast cancer, differing clinical benefits and gene expression analyses suggest a divergent HER2 subgroup. We aimed to investigate whether the basal HER2 subtype of breast cancer has distinguished characteristics.

Methods

We performed a substudy by using data from a retrospective multi-institutional cohort of JBCRG-C03. Between 2001 and 2011, we identified 184 eligible patients who received concurrent neo-adjuvant chemotherapy (NAC) with trastuzumab for hormone receptor-negative and HER2-positive breast cancer. We defined basal HER2 subtype breast cancer as HER2-positive, ER/PgR-negative, and basal markers (EGFR, CK14 or CK5/6) positive by immunohistochemistrical evaluation. The pathologic complete response (pCR) and disease-free survival (DFS) rates were compared between the two subtypes.

Results

A total of 127 (69.0%) patients achieved pCR after NAC and 29 (15.8%) patients experienced events of DFS within a 42 month median follow-up period (interquartile range 26–58 months). Although the basal HER2 subtype was related with poor DFS (3 year DFS: non-basal HER2, 95.0%; basal HER2, 86.9%; adjusted HR 3.4; 95% CI 1.2–14.5), neither the subtype (pCR: non-basal HER2, 75%; basal HER2, 66.7%; adjusted OR 0.60; 95% CI 0.27–1.28) nor the degree of expression of basal markers was significantly related with the pCR rate.

Conclusion

Basal HER2 phenotype showed poor DFS, but equivalent pCR rate after concurrent neo-adjuvant chemotherapy with trastuzumab. A different treatment approach to basal-HER2 type is needed even for cases that achieved adequate clinical response after NAC.

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Title: Effectiveness of neo-adjuvant systemic therapy with trastuzumab for basal HER2 type breast cancer: results from retrospective cohort study of Japan Breast Cancer Research Group (JBCRG)-C03
Authors: Yasuaki Sagara
Masahiro Takada
Yasuyo Ohi
Shoichiro Ohtani
Sasagu Kurozumi
Kenichi Inoue
Yoshimasa Kosaka
Masaya Hattori
Toshinari Yamashita
Shintaro Takao
Nobuaki Sato
Hiroji Iwata
Masafumi Kurosumi
Masakazu Toi
Publication date: 01-10-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-4873-0

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