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Characterization of HER2-low breast cancer in young women with germline BRCA1/2 pathogenetic variants: Results of a large international retrospective cohort study

Title: Characterization of HER2-low breast cancer in young women with germline BRCA1/2 pathogenetic variants: Results of a large international retrospective cohort study
Authors: Schettini, F; Blondeaux, E; Molinelli, C; Bas, R; Kim, HJ; Di Meglio, A; Bernstein Molho, R; Linn, SC; Pogoda, K; Carrasco, E; Punie, K; Agostinetto, E; Lopetegui-Lia, N; Phillips, KA; Toss, A; Rousset-Jablonski, C; Acheritogaray, M; Ferrari, A; Paluch-Shimon, S; Fruscio, R; Cui, W; Wong, SM; Vernieri, C; Dieci, MV; Matikas, A; Rozenblit, M; Villarreal-Garza, C; De Marchis, L; Puglisi, F; Vasconcelos de Matos, L; Mariño, M; Teixeira, L; Graffeo, R; Rognone, A; Chirco, A; Antone, N; Abdou, Y; Marhold, M; Božović-Spasojević, I; Cortés Salgado, A; Carmisciano, L; Bruzzone, M; Curigliano, G; Prat, A; Lambertini, M
Publisher Information: WILEY
Publication Year: 2024
Collection: The University of Melbourne: Digital Repository
Description: BACKGROUND: Breast cancer (BC) in women aged ≤40 years carrying germline pathogenetic variants (PVs) in BRCA1/2 genes is infrequent but often associated with aggressive features. Human epidermal growth factor receptor 2 (HER2)-low-expressing BC has recently emerged as a novel therapeutic target but has not been characterized in this rare patient subset. METHODS: Women aged ≤40 years with newly diagnosed early-stage HER2-negative BC (HER2-0 and HER2-low) and germline BRCA1/2 PVs from 78 health care centers worldwide were retrospectively included. Chi-square test and Student t-test were used to describe variable distribution between HER2-0 and HER2-low. Associations with HER2-low status were assessed with logistic regression. Kaplan-Meier method and Cox regression analysis were used to assess disease-free survival (DFS) and overall survival. Statistical significance was considered for p ≤ .05. RESULTS: Of 3547 included patients, 32.3% had HER2-low BC, representing 46.3% of hormone receptor-positive and 21.3% of triple-negative (TN) tumors. HER2-low vs. HER2-0 BC were more often of grade 1/2 (p < .001), hormone receptor-positive (p < .001), and node-positive (p = .003). BRCA2 PVs were more often associated with HER2-low than BRCA1 PVs (p < .001). HER2-low versus HER2-0 showed better DFS (hazard ratio [HR], 0.86; 95% CI, 0.76-0.97) in the overall population and more favorable DFS (HR, 0.78; 95% CI, 0.64-0.95) and overall survival (HR, 0.65; 95% CI, 0.46-0.93) in the TN subgroup. Luminal A-like tumors in HER2-low (p = .014) and TN and luminal A-like in HER2-0 (p = .019) showed the worst DFS. CONCLUSIONS: In young patients with HER2-negative BC and germline BRCA1/2 PVs, HER2-low disease was less frequent than expected and more frequently linked to BRCA2 PVs and associated with luminal-like disease. HER2-low status was associated with a modestly improved prognosis.
Document Type: article in journal/newspaper
Language: English
ISSN: 0008-543X
Relation: NHMRC/288704; NHMRC/454508; https://hdl.handle.net/11343/349024
Availability: https://hdl.handle.net/11343/349024
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0 ; CC BY-NC-ND
Accession Number: edsbas.18EF9B3D
Database: BASE