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Open Access 01-08-2020 | Metastasis | Clinical trial

Estrogen, progesterone, and human epidermal growth factor receptor 2 discordance between primary and metastatic breast cancer

Authors: Vincent Walter, Chiara Fischer, Thomas M. Deutsch, Catherine Ersing, Juliane Nees, Florian Schütz, Carlo Fremd, Eva-Maria Grischke, Peter Sinn, Sara Y. Brucker, Andreas Schneeweiss, Andreas D. Hartkopf, Markus Wallwiener

Published in: Breast Cancer Research and Treatment | Issue 1/2020

Abstract

Background

The estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) statuses are frequently discordant between the primary tumor and metastatic lesions in metastatic breast cancer. This can have important therapeutic implications.

Patients and methods

In all, 541 patients with available receptor statuses from both primary tumor and metastatic lesion treated at Heidelberg and Tuebingen University Hospitals between 1982 and 2018 were included.

Results

Statistically significant discordance rates of 14% and 32% were found for ER and PR. HER2 status was statistically insignificantly discordant in 15% of patients. Gain in HER2 positivity was associated with an improved overall survival, whereas loss of HR positivity was associated with worse overall survival. Antiendocrine treatment differed in 20% of cases before and after biopsy and HER2-directed treatment in 14% of cases.

Conclusions

Receptor statuses are discordant between primary tumor and metastasis in a considerable fraction of patients with metastatic breast cancer. Next to a highly presumed predictive value with respect to efficacy of endocrine and HER2-targeted therapy, discordance seems to provide prognostically relevant information. Where feasible, metastatic lesions should be biopsied in accordance with current guidelines.

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Title: Estrogen, progesterone, and human epidermal growth factor receptor 2 discordance between primary and metastatic breast cancer
Authors: Vincent Walter
Chiara Fischer
Thomas M. Deutsch
Catherine Ersing
Juliane Nees
Florian Schütz
Carlo Fremd
Eva-Maria Grischke
Peter Sinn
Sara Y. Brucker
Andreas Schneeweiss
Andreas D. Hartkopf
Markus Wallwiener
Publication date: 01-08-2020
Publisher: Springer US
Keywords: Metastasis
Breast Cancer
Breast Cancer
Progesterone
Estrogens
Published in: Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05746-8

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Abstract

Background

Patients and methods

Results

Conclusions

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