Elena Ongaro1,2, Lorenzo Gerratana1,3, Marika Cinausero1,2, Giacomo Pelizzari1,3, Elena Poletto1, Manuela Giangreco3,4, Claudia Andreetta1, Stefano Pizzolitto5, Carla Di Loreto3,6, Alessandro Marco Minisini1, Mauro Mansutti1, Stefania Russo1, Gianpiero Fasola1, Fabio Puglisi3,7. 1. Department of Oncology, Azienda Sanitaria Universitaria Integrata S Maria della Misericordia, Pz.le S Maria della Misericordia 15, 33100 Udine (UD), Italy. 2. Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata Policlinico GB Rossi, Pz.le LA Scuro 10, 37134 Verona (VR), Italy. 3. Department of Medicine (DAME), University of Udine, Pz.le Kolbe 3, 33100 Udine (UD), Italy. 4. Institute of Hygiene & Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata S Maria della Misericordia, Pz.le S Maria della Misericordia 15, 33100 Udine (UD), Italy. 5. Department of Pathology, Azienda Sanitaria Universitaria Integrata S Maria della Misericordia, Pz.le S Maria della Misericordia 15, 33100 Udine (UD), Italy. 6. Institute of Pathology, Azienda Sanitaria Universitaria Integrata S Maria della Misericordia, Pz.le S Maria della Misericordia 15, 33100 Udine (UD), Italy. 7. Department of Clinical Oncology, CRO Aviano National Cancer Institute, Via Franco Gallini 2, 33081 Aviano (PN), Italy.
Abstract
AIM: Discordance between primary tumor and paired metastases biology has been widely detected in metastatic breast cancer. The aim of this study was to evaluate the prognostic impact of Ki67, estrogen receptor (ER), progesterone receptor (PR) and HER2 discordance. METHODS: We retrospectively analyzed a cohort of 544 patients affected by metastatic breast cancer. Variation in ER, PR, Ki67 and HER2 expression between primary site and recurrence was tested through the McNemar test. RESULTS: A significant variation was observed in respect to ER, PR and Ki67 status (12.65%, p = 0.0072; 49.71%, p < 0.0001; 35%, p < 0.0001, respectively). Among patients with ER or PR discordance, the driver of therapeutic decisions was the ER status. Moreover, we observed a therapy-related reduction of ER in taxanes or aromatase inhibitors-exposed patients (odds ratio: 3.59; 95% CI: 1.66-7.77; p = 0.001 and odds ratio: 2.07; 95% CI: 0.96-4.44; p = 0.06, respectively). CONCLUSION: Biopsy of metastatic lesions may influence the decision-making process translating into better outcome.
AIM: Discordance between primary tumor and paired metastases biology has been widely detected in metastatic breast cancer. The aim of this study was to evaluate the prognostic impact of Ki67, estrogen receptor (ER), progesterone receptor (PR) and HER2 discordance. METHODS: We retrospectively analyzed a cohort of 544 patients affected by metastatic breast cancer. Variation in ER, PR, Ki67 and HER2 expression between primary site and recurrence was tested through the McNemar test. RESULTS: A significant variation was observed in respect to ER, PR and Ki67 status (12.65%, p = 0.0072; 49.71%, p < 0.0001; 35%, p < 0.0001, respectively). Among patients with ER or PR discordance, the driver of therapeutic decisions was the ER status. Moreover, we observed a therapy-related reduction of ER in taxanes or aromatase inhibitors-exposed patients (odds ratio: 3.59; 95% CI: 1.66-7.77; p = 0.001 and odds ratio: 2.07; 95% CI: 0.96-4.44; p = 0.06, respectively). CONCLUSION: Biopsy of metastatic lesions may influence the decision-making process translating into better outcome.
Entities:
Keywords:
discordance; metastatic breast cancer; paired biopsies
Authors: Marianne Gnanamuttupulle; Oliver Henke; Shilanaiman Hilary Ntundu; Furaha Serventi; Leila E Mwakipunda; Patrick Amsi; Alex Mremi; Kondo Chilonga; David Msuya; Samuel G Chugulu Journal: Ecancermedicalscience Date: 2021-09-07