Jane L Meisel1, Jing Zhao2, Aili Suo3, Chao Zhang4, Zhimin Wei2, Caitlin Taylor1, Ritu Aneja5, Uma Krishnamurti6, Zaibo Li7, Rita Nahta8, Ruth O'Regan9, Xiaoxian Li10. 1. Department of Hematology and Medical Oncology, Emory University, Atlanta, GA. 2. Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China. 3. Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 4. Biostatistics and Bioinformatics Shared Resource, Emory University, Atlanta, GA. 5. Department of Biology, Georgia State University, Atlanta, GA. 6. Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA. 7. Department of Pathology, Ohio State University, Columbus, OH. 8. Department of Pharmacology, Emory University, Atlanta, GA. 9. Department of Medicine, University of Wisconsin, Madison, WI. 10. Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA. Electronic address: xli40@emory.edu.
Abstract
BACKGROUND: HER2-targeted neoadjuvant therapy has high efficacy in treating HER2-positive breast cancer. Response to neoadjuvant therapy helps clinicians make treatment decisions and make estimates about prognosis. This study examined clinicopathologic features to determine which may be most predictive of response to neoadjuvant therapy in HER2+ breast cancer. PATIENTS AND METHODS: Patients with HER2+ breast cancer (n = 173) who had an initial biopsy performed between 2010 and 2016 were identified at our institution. Tumor response was evaluated on excisional specimens using the MD Anderson residual cancer burden (RCB) classification. Tumors with pathologic complete response (defined as no residual invasive carcinoma in the breast and lymph nodes) and RCB-I were classified as having response and tumors with RCB-II and -III as having no response. Patient age, tumor size, nuclear grade (1/2 vs. 3), mitosis, Nottingham grade, HER2 immunohistochemistry (1/2+ vs. 3+), HER2/CEP17 (chromosome enumeration probe 17) ratio, HER2 copy number, estrogen receptor, progesterone receptor, Ki-67, and tumor-infiltrating lymphocytes (TIL) were evaluated and correlated with response. TILs were evaluated for an average and also for the hot spot/total tumor stromal ratio. RESULTS: Small tumor size, low estrogen receptor and progesterone receptor expression, HER2 immunohistochemistry 3+, high Ki-67, high HER2/CEP17 ratio, and high HER2 copy number were significantly associated with response (all P < .05). TIL hot spot was associated with RCB in univariate (P < .05) but not multivariate analyses. CONCLUSION: Clinicopathologic features may help predict HER2+ breast cancer response to neoadjuvant therapy. Larger studies would be useful to confirm these associations, which may have relevance to clinical practice.
BACKGROUND:HER2-targeted neoadjuvant therapy has high efficacy in treating HER2-positive breast cancer. Response to neoadjuvant therapy helps clinicians make treatment decisions and make estimates about prognosis. This study examined clinicopathologic features to determine which may be most predictive of response to neoadjuvant therapy in HER2+ breast cancer. PATIENTS AND METHODS: Patients with HER2+ breast cancer (n = 173) who had an initial biopsy performed between 2010 and 2016 were identified at our institution. Tumor response was evaluated on excisional specimens using the MD Anderson residual cancer burden (RCB) classification. Tumors with pathologic complete response (defined as no residual invasive carcinoma in the breast and lymph nodes) and RCB-I were classified as having response and tumors with RCB-II and -III as having no response. Patient age, tumor size, nuclear grade (1/2 vs. 3), mitosis, Nottingham grade, HER2 immunohistochemistry (1/2+ vs. 3+), HER2/CEP17 (chromosome enumeration probe 17) ratio, HER2 copy number, estrogen receptor, progesterone receptor, Ki-67, and tumor-infiltrating lymphocytes (TIL) were evaluated and correlated with response. TILs were evaluated for an average and also for the hot spot/total tumor stromal ratio. RESULTS: Small tumor size, low estrogen receptor and progesterone receptor expression, HER2 immunohistochemistry 3+, high Ki-67, high HER2/CEP17 ratio, and high HER2 copy number were significantly associated with response (all P < .05). TIL hot spot was associated with RCB in univariate (P < .05) but not multivariate analyses. CONCLUSION: Clinicopathologic features may help predict HER2+ breast cancer response to neoadjuvant therapy. Larger studies would be useful to confirm these associations, which may have relevance to clinical practice.
Authors: Thi Truc Anh Nguyen; Lauren M Postlewait; Chao Zhang; Jane L Meisel; Ruth O'Regan; Sunil Badve; Kevin Kalinsky; Xiaoxian Li Journal: Breast Cancer Res Treat Date: 2022-01-27 Impact factor: 4.872
Authors: Hongxiao Li; Jigang Wang; Zaibo Li; Melad Dababneh; Fusheng Wang; Peng Zhao; Geoffrey H Smith; George Teodoro; Meijie Li; Jun Kong; Xiaoxian Li Journal: Front Med (Lausanne) Date: 2022-06-14
Authors: Ciara C O'Sullivan; Karla V Ballman; Linda McCall; Anuhya Kommalapati; Tyler Zemla; Anna Weiss; Melissa Mitchell; Victoria Blinder; Nadine M Tung; William J Irvin; Myounghee Lee; Matthew P Goetz; William Fraser Symmans; Virginia F Borges; Ian Krop; Lisa A Carey; Ann H Partridge Journal: Future Oncol Date: 2021-10-12 Impact factor: 3.674
Authors: Emad A Rakha; Islam M Miligy; Cecily M Quinn; Elena Provenzano; Abeer M Shaaban; Caterina Marchiò; Michael S Toss; Grace Gallagy; Ciara Murray; Janice Walshe; Ayaka Katayama; Karim Eldib; Nahla Badr; Bruce Tanchel; Rebecca Millican-Slater; Colin Purdie; Dave Purnell; Sarah E Pinder; Ian O Ellis; Andrew H S Lee Journal: Br J Cancer Date: 2021-03-24 Impact factor: 7.640
Authors: Tamera J Lillemoe; Mara Rendi; Michaela L Tsai; Monica Knaack; Rina Yarosh; Erin Grimm; Barbara Susnik; Janet Krueger; Susan Olet; Karen K Swenson Journal: Int J Breast Cancer Date: 2021-05-24