Immunohistochemical Status Predicts Pathologic Complete Response to Neoadjuvant Therapy in HER2-Overexpressing Breast Cancers
2024

HER2 Status and Pathologic Response in Breast Cancer

Sample size: 40711 publication 10 minutes Evidence: high

Author Information

Author(s): Winer Leah MD, Ruth Karen J. MS, Bleicher Richard J. MD, Nagarathinam Rajeswari MD, McShane Melissa MD, Porpiglia Andrea S. MD, Pronovost Mary T. MD, Aggon Allison DO, Williams Austin D. MD, MSEd

Primary Institution: Fox Chase Cancer Center

Hypothesis

Does pathologic complete response (pCR) vary by HER2 immunohistochemistry (IHC) status in breast cancer patients undergoing neoadjuvant therapy?

Conclusion

HER2 IHC status predicts pCR and may help select breast cancer patients who derive the greatest benefit from neoadjuvant therapy.

Supporting Evidence

  • IHC3+ patients had a higher breast pCR rate of 54% compared to 22% for IHC2+/ISH+ patients.
  • Overall, breast pCR was 49% and nodal pCR was 64% across the cohort.
  • Multivariable analysis showed IHC3+ status as an independent predictor of pCR.

Takeaway

This study found that patients with a certain type of breast cancer (HER2 IHC3+) are more likely to have a complete response to treatment than those with a different type (HER2 IHC2+/ISH+).

Methodology

Patients with stage I–III HER2+ breast cancer undergoing neoadjuvant therapy and surgery were identified from the National Cancer Database and stratified by IHC status.

Potential Biases

Potential biases may arise from the retrospective nature of the study and the use of a large database that may not capture all relevant clinical details.

Limitations

The study is retrospective and relies on a large cancer database, which may lack detailed treatment regimen data and other clinical variables.

Participant Demographics

The cohort included 83% IHC3+ and 17% IHC2+/ISH+ patients, with a median age of 53 years.

Statistical Information

P-Value

p<0.0001

Confidence Interval

CI 3.65–4.19

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1245/s10434-024-16470-8

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication