HER2-low status improves prognosis prediction in breast cancer patients receiving neoadjuvant treatment:A comparison of pathological stage,modified CPS+EG scoring system,and Neo-Bioscore  

作　　者：Yujie Lu Siji Zhu Chenghui Wu Xiaochun Fei Kunwei Shen Xiaosong Chen 

机构地区：[1]Department of General Surgery,Comprehensive Breast Health Center,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China [2]Department of Pathology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China

出　　处：《Chinese Journal of Cancer Research》2024年第6期729-741,共13页中国癌症研究(英文版)

基　　金：supported by the National Natural Science Foundation of China(No.82072937 and 82072897);Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2024QNB05)。

摘　　要：Objective:To explore the prognosis-predictive influence of human epidermal growth factor receptor 2(HER2)-low status in breast cancer patients after neoadjuvant therapy(NAT).Methods:Consecutive patients with invasive breast cancer who underwent NAT and surgery from January 2009 to December 2020 at multiple centers were included.A modified CPS+EG scoring system that integrates HER2-low status,CPS+EGH_(low)was developed.Multiple scoring systems were compared via receiver operating characteristic curves with the area under curve(AUC),the Akaike information criterion,the C-index,and calibration curves.Results:A total of 2,141 patients were included:1,074,640,and 427 patients in the training,internal validation,and external validation groups,respectively.HER2-low patients had a significantly better breast cancer-specific survival(BCSS,P=0.008)and recurrence-free interval(RFI,P=0.030)compared to HER2-zero patients(P=0.038)but inferior outcomes than HER2-amplified ones(BCSS,P=0.002;RFI,P<0.001).The CPS+EGH_(low)(AUC:0.846,0.817,0.901)could stratify patients according to BCSS in training,internal validation,and external validation group,respectively,overperforming pathological stage(PS)(AUC:0.746,0.779,0.754),CPS+EG(AUC:0.771,0.752,0.748),and Neo-Bioscore(AUC:0.783,0.777,0.786,all P<0.05).Conclusions:HER2-low status showed a significant prognostic value in breast cancer patients after NAT.The CPS+EGH_(low)model significantly outperformed PS,CPS+EG,and Neo-Bioscore in clinical outcome prediction,which may guide further therapy targeting HER2-low.

关 键 词：Breast cancer HER2-low neoadjuvant therapy PROGNOSIS CPS+EGH_(low) 

分 类 号：R73[医药卫生—肿瘤]