{"doi":"10.1016/j.esmoop.2024.103973","title":"Clinical outcomes of early-stage triple-negative breast cancer after neoadjuvant chemotherapy according to HER2-low status☆","abstract":"BACKGROUND: The impact of human epidermal growth factor receptor 2 (HER2) expression determined by immunohistochemistry (IHC) on outcomes in early-stage triple-negative breast cancer (eTNBC) is unclear. Using a large, multi-institutional cohort, we evaluated outcomes by HER2 IHC status in patients with eTNBC who received neoadjuvant therapy (NAT). PATIENTS AND METHODS: Patients with stage I-III TNBC who received NAT and underwent surgery from January 2016 to June 2019 were identified from three databases. HER2 expression was defined as low (IHC1+ or 2+/FISH not amplified) or HER2 IHC score 0 by local testing at diagnosis. Pathological complete response (pCR) rates were compared using logistic regression adjusted for multiple factors. Survival outcomes were estimated using Kaplan-Meier and Cox proportional hazards models. RESULTS: Among 977 consecutive patients, 388 (39.7%) had HER2-low and 589 (60.3%) had HER2 IHC score 0 tumors. Median age at eTNBC diagnosis was 50.3 years (range 21.0-83.4 years). At baseline, clinical nodal positivity rate was significantly higher in HER2-low (55.0%) versus HER2 IHC score 0 tumors (46.6%) (P = 0.011); pCR rates were similar (32.0% versus 32.6%; adjusted P = 0.924). At a median follow-up of 3.5 years, recurrence-free survival (RFS) did not vary significantly between HER2-low versus HER2 IHC score 0 among patients with pCR (adjusted P = 0.368) or residual disease (RD) after NAT (adjusted P = 0.573). Distant RFS and overall survival (OS) did not differ by HER2 category for patients with pCR [distant RFS (DRFS), adjusted P = 0.509; OS, adjusted P = 0.514] or RD (DRFS, adjusted P = 0.812; OS, P = 0.285). Discordance of tumor HER2 status was seen in 31.1% of HER2 IHC score 0 cases, with HER2 expression observed post-treatment; 34.8% of HER2-low cases showed discordance, with absent HER2 expression in RD. CONCLUSIONS: In this large cohort of patients with eTNBC treated with NAT, HER2-low status was not associated with pCR or survival after adjusting for clinical factors. The discordance in HER2 IHC pre- and post-NAT likely reflects challenges in HER2 quantification and heterogeneity.","journal":"ESMO Open","year":2024,"id":435862,"datarank":0.38474240361923057,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"self_citation_contribution":0.38474240361923057,"citation_network_contribution":0.0,"self_endowment_contribution":0.38474240361923057,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7015,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1243468,"name":"Danielle Brandes Zakon","orcid":"0000-0002-0532-5686","position":1,"is_corresponding":false},{"id":626043,"name":"Qingchun Jin","orcid":"0000-0001-6388-5123","position":2,"is_corresponding":false},{"id":1243469,"name":"Ava Strahan","orcid":"0009-0007-0002-8758","position":3,"is_corresponding":false},{"id":1069704,"name":"Melissa Grimm","orcid":"0009-0001-4244-7658","position":4,"is_corresponding":false},{"id":56748,"name":"Melissa E. Hughes","orcid":"0000-0001-6190-9101","position":5,"is_corresponding":false},{"id":331535,"name":"Mathew Cherian","orcid":"0000-0002-0380-2012","position":6,"is_corresponding":false},{"id":1243994,"name":"Julie Vincuilla","orcid":null,"position":7,"is_corresponding":false},{"id":1243995,"name":"Tonia Parker","orcid":null,"position":8,"is_corresponding":false},{"id":1075902,"name":"Paolo Tarantino","orcid":"0000-0001-8686-0228","position":9,"is_corresponding":false},{"id":245094,"name":"Elizabeth A. Mittendorf","orcid":"0000-0002-9762-8536","position":10,"is_corresponding":false},{"id":13663,"name":"Tari A. King","orcid":"0000-0003-3602-2351","position":11,"is_corresponding":false},{"id":309287,"name":"Vicente Valero","orcid":"0000-0001-5913-7480","position":12,"is_corresponding":false},{"id":228239,"name":"Debu Tripathy","orcid":"0000-0002-5711-2404","position":13,"is_corresponding":false},{"id":56758,"name":"Sara M. Tolaney","orcid":"0000-0002-5940-8671","position":14,"is_corresponding":false},{"id":352704,"name":"Nabihah Tayob","orcid":"0000-0001-6088-167X","position":15,"is_corresponding":false},{"id":3753,"name":"Nancy U. Lin","orcid":"0000-0003-2263-5413","position":16,"is_corresponding":false},{"id":38074,"name":"Daniel G. Stover","orcid":"0000-0001-9003-8165","position":17,"is_corresponding":false},{"id":670554,"name":"Carlos H. Bárcenas","orcid":"0000-0001-5377-9167","position":18,"is_corresponding":false},{"id":254178,"name":"Ana C. Garrido-Castro","orcid":"0000-0002-5989-6636","position":19,"is_corresponding":false},{"id":814472,"name":"Akshara Singareeka Raghavendra","orcid":"0000-0002-6425-4400","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:00:08.103086Z","pmid":"39500139","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}