{"doi":"10.17615/hgdw-v761","title":"HER2-enriched subtype and pathological complete response in HER2-positive breast cancer: A systematic review and meta-analysis","abstract":"Background: HER2-positive (HER2+) breast cancer (BC) comprises all the four PAM50 molecular subtypes. Among these, the HER2-Enriched (HER2-E) appear to be associated with higher pathological complete response (pCR) rates following anti-HER2-based regimens. Here, we present a meta-analysis to validate the association of the HER2-E subtype with pCR following anti-HER2-based neoadjuvant treatments with or without chemotherapy (CT). Methods: A systematic literature search was performed in February 2019. The primary objective was to compare the association between HER2-E subtype (versus others) and pCR. Selected secondary objectives were to compare the association between 1) HER2-E subtype and pCR in CT-free studies, 2) HER2-E subtype within hormone receptor (HR)-negative and HR+ disease and 3) HR-negative disease (versus HR+) and pCR in all patients and within HER2-E subtype. A random-effect model was applied. The Higgins’ I2 was used to quantify heterogeneity. Results: Sixteen studies were included, 5 of which tested CT-free regimens. HER2-E subtype was significantly associated with pCR in all patients (odds ratio [OR] = 3.50, p < 0.001, I2 = 33%), in HR+ (OR = 3.61, p < 0.001, I2 = 1%) and HR-negative tumors (OR = 2.28, p = 0.01, I2 = 47%). In CT-free studies, HER2-E subtype was associated with pCR in all patients (OR = 5.52, p < 0.001, I2 = 0%) and in HR + disease (OR = 4.08, p = 0.001, I2 = 0%). HR-negative status was significantly associated with pCR compared to HR + status in all patients (OR = 2.41, p < 0.001, I2 = 30%) and within the HER2-E subtype (OR = 1.76, p < 0.001, I2 = 0%). Conclusions: The HER2-E biomarker identifies patients with a higher likelihood of achieving a pCR following neoadjuvant anti-HER2-based therapy beyond HR status and CT use. Future trial designs to escalate or de-escalate systemic therapy in HER2+ disease should consider this genomic biomarker.","journal":"UNC Libraries","year":2021,"id":190536,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9585,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":755398,"name":"V. Guarneri","orcid":null,"position":1,"is_corresponding":false},{"id":541477,"name":"C.M. 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Carey","orcid":null,"position":13,"is_corresponding":false},{"id":755408,"name":"T. Pascual","orcid":null,"position":14,"is_corresponding":false},{"id":755409,"name":"J.C. Brase","orcid":null,"position":15,"is_corresponding":false},{"id":755410,"name":"B. Gonzalez-Farre","orcid":null,"position":16,"is_corresponding":false},{"id":755411,"name":"P. Galván","orcid":null,"position":17,"is_corresponding":false},{"id":755412,"name":"S. De Placido","orcid":null,"position":18,"is_corresponding":false},{"id":755413,"name":"M. Locci","orcid":null,"position":19,"is_corresponding":false},{"id":755414,"name":"M.F. Rimawi","orcid":null,"position":20,"is_corresponding":false},{"id":167726,"name":"B. Conte","orcid":null,"position":21,"is_corresponding":false},{"id":755415,"name":"M. Muñoz","orcid":null,"position":22,"is_corresponding":false},{"id":460167,"name":"B. Adamo","orcid":null,"position":23,"is_corresponding":false},{"id":755416,"name":"G. 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