Objective To investigate the clinicopathological characteristics of HER2 protein expression in different degrees in human epidermal growth factor receptor 2 (HER2) negative breast cancer and the factors related to the efficacy of neoadjuvant chemotherapy in breast cancer with low HER2 expression. Methods The clinicopathological data of 161 patients with HER2-negative breast cancer who received neoadjuvant chemotherapy in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from March 2019 to March 2022 were retrospectively collected. The difference of clinical and pathological characteristics of patients with different levels of HER2 protein expression were analyzed, and the factors influencing the pathological complete remission (pCR) rate of breast cancer patients with low HER2 expression after neoadjuvant chemotherapy with unconditional logistic regression model were analyzed. Results Among 161 HER2 negative breast cancer patients, 108 cases were low HER2 expression, accounting for 67.1%. Compared with those with zero expression of HER2 [immunohistochemistry (IHC) 0], the patients with low HER2 expression had higher axillary lymph node metastasis rate (P=0.048), lower histological grade (P=0.006), and higher proportion of positive hormone receptor expression (P<0.001). There was no significant difference in pCR rate among the HER2 IHC 0, IHC 1+ and IHC 2+ / in situ hybridization (ISH)– (P=0.099) , and the pCR rate of low expression of HER2 was lower than that of zero expression of HER2 in the general population and Luminal subgroup, and the difference was statistically significant (P<0.05). There was no significant difference in triple negative breast cancer subgroup (P=0.814). The logistic regression analysis showed that age, histological grade and estrogen receptor expression status were independent influencing factors for pCR rate after neoadjuvant chemotherapy with low HER2 expression (P<0.05). Conclusions Different degrees of HER2 protein expressions in patients with HER2-negative breast cancer have unique clinicopathological characteristics. The pCR rate of neoadjuvant chemotherapy in patients with low HER2-expression breast cancer is lower than that in patients with zero HER2-expression breast cancer. Age, histological grade and estrogen receptor expression status are independent factors influencing the pCR rate of neoadjuvant chemotherapy in patients with low HER2-expression breast cancer.
Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
ObjectiveTo investigate the expression of epidermal growth factor receptor (EGFR) in triple-negative breast cancer (TNBC) and its relation with clinicopathologic features. MethodsA computer search of PubMed, Web of Science, CNKI, Wanfang Data, and VIP databases were conducted to select clinical studies on EGFR expression in the TNBC according to the inclusion and exclusion criteria, and the search period was from database establishment to January 2022. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature before conducting meta-analysis using RevMan 5.4 software. ResultsA total of 28 studies including 7 956 patients were included. The results of meta-analysis showed that the positive rate of EGFR expression in the TNBC patients was higher than that in the non-TNBC patients [OR=5.16, 95%CI (4.04, 6.58), P<0.000 01], and the proportions of patients with axillary lymph node metastasis [OR=3.11, 95%CI (1.56, 6.19), P=0.001] and with tumor diameter >2 cm [OR=2.09, 95%CI (1.18, 3.72), P=0.01] in the patients with EGFR positive were higher than those the patients with EGFR negative, no correlation was found that the proportion of patients with histological WHO classification 3 between the patients with EGFR positive expression and EGFR negative expression (P=0.07). ConclusionFrom the results of this meta-analysis, EGFR expression might be associated with the occurrence, development, and metastasis of patients with TNBC.
Objective To analyze the factors associated with the adoption of targeted therapy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer and to generate evidence to inform decision-making on public security policy regarding innovative anticancer medicines for the benefit of patients. Methods The study population comprised female patients diagnosed with HER2-positive breast cancer and treated at Fujian Cancer Hospital from 2014 to 2020. The patients were eligible for targeted therapy. The demographic and sociological characteristics and clinical information of patients were extracted from the hospital information system. We performed binary logistic regression analysis of factors associated with the adoption of targeted therapy in patients with HER2-positive breast cancer. We also divided the participants into two groups according to their tumor stage for subgroup analysis. Results A total of 1 041 female patients with HER2-positive breast cancer were included, among them, 803 received targeted therapy. In September 2017, molecular-targeted medicines for HER2-positive breast cancer began to be included in the local basic health insurance program. Only 282 (35.1%) patients adopted targeted therapy before September 2017, after which this number increased to 521 (64.9%). Among the patients who adopted targeted therapy, most were formally employed (45.8%) and enrollees of the urban employee health insurance program (66.0%). Among those who did not adopt targeted therapy, most were unemployed (42.4%) and enrollees of the resident health insurance program (50.0%). Binary logistic regression analysis revealed that patient occupation, gene expression of estrogen receptor, tumor stage, surgery or not, radiotherapy or not, and undergoing treatment before or after September 2017 were correlated with the adoption of targeted therapy (P<0.05). Conclusions Inclusion of targeted medicines for HER2-positive breast cancer in the health insurance program substantially increased the overall administration of these therapies. Individual affordability is a critical factor associated with the application of targeted therapy in eligible patients. Future policies should enhance the public security of patients with a relatively weak ability to pay and provide insurance coverage for innovative anti-cancer medicines.
ObjectiveTo analyze the clinicopathologic characteristics and prognosis of human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients with different expression status of estrogen receptor (ER). MethodsThe patients with HER2-negative breast cancer met the inclusion and exclusion criteria and were treated in the Affiliated Hospital of Southwest Medical University from January 1, 2017 to December 31, 2019 were retrospectively collected, and then were assigned into 3 groups according to the ER expression status: ER-negative (ER expression positive rate <1%) group, ER-low expression (ER expression positive rate 1%–10%) group, and ER expression positive rate >10% group. The differences of clinicopathologic characteristics, therapy, and prognosis among the 3 groups were compared. And the risk factors affecting recurrence and metastasis of patients with ER-low expression were analyzed by Cox proportional hazards regression model. ResultsA total of 610 patients with HER2-negative breast cancer were included in this study, including 130 patients in the ER-negative group, 48 patients in the ER-low expression group, and 432 patients in the ER expression positive rate >10% group. The Bonferroni method was used to correct the test level after pairwise comparison, it was found that the histological grade was later (P<0.001, P=0.023) and the Ki-67 expression was higher (P<0.001, P=0.023) in the ER-negative group and ER-low expression group as compared with the ER expression positive rate >10% group; The proportion of the patients receiving chemotherapy in the ER-negative group was higher than that of the ER expression positive rate >10% group (χ2=10.310, P=0.001), while which had no statistical difference between the ER-low expression group and the ER-negative group or the ER expression positive rate >10% group (Fisher exact probability method, P=1.000; χ2= 3.585, P=0.058); The proportion of patients receiving endocrine therapy in the ER-low expression group was higher than that in the ER-negative group (χ2=36.333, P<0.001) and lower than the ER expression positive rate >10% group (χ2=246.996, P<0.001). The difference in disease-free survival (DFS) curves among 3 groups was statistically significant (χ2=46.805, P<0.001); There were no statistical differences in the overall survival (OS) curve and DFS curve between the ER-negative group and the ER-low expression group (Two stage test, P=0.786; χ2=1.141, P=0.286), and which in the ER expression positive rate >10% group were significantly better than thoses in the ER-negative group (χ2=10.137, P=0.001; χ2=39.344, P<0.001) and the ER-low expression group (χ2=4.075, P=0.044; χ2=31.911, P<0.001). The results of multivariate Cox proportional hazards regression analysis showed that N1 and N2 [N0 as reference: RR (95%CI)=7.740 (1.939, 30.897), P=0.004; RR (95%CI)=9.513 (1.990, 45.478), P=0.005) and T3 [T1 as reference: RR (95%CI)=27.357 (2.188, 342.041), P=0.010] increased the probabilities of recurrence and metastasis HER2-negative breast cancer patients with ER-low expression. ConclusionsAccording to results of this study, patients with HER2-negative breast cancer showed certain differences in histological grade and Ki-67 expression among patients with three different ER expression status, but no statistical difference is found between ER-low expression and ER-negative breast cancer, and the prognoses of both are worse than that of ER expression positive rate >10% breast cancer patients. Lymph node metastasis and larger tumor are risk factors affecting recurrence and metastasis in ER-low expression breast cancer patients.
ObjectiveTo investigate the quality of life (QOL) and its influencing factors of patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer returning to social life after treatment.MethodsFunctional assessment of cancer therapy-breast scale (FACT-B Scale) was adopted to investigate the QOL of the HER2 positive breast cancer survivors, who were admitted and treated during January 2015 and October 2019 in Fujian Provincial Hospital. The demographic, social and economic data, as well as the clinical information of the responded survivors were collected. Logistic regression model was adopted to analyze factors associated with the QOL of the responded survivors.ResultsA total of 117 responded survivors were included. The median of the FACT-B scale was 106.0 (91.0, 121.3) points out of 148 points (71.6%). With the control of the demographic, social and economic status of the responded survivors, as well as the time from diagnosis and treatment to responding to the follow-up, we found that "having other chronic conditions" was the risk factor for the HER2 positive breast cancer survivors to have higher QOL in the social life after treatment (OR=4.17, 95%CI 1.33 to 15.37, P=0.01).ConclusionsThe overall QOL of the HER2 positive breast cancer survivors in the social life after treatment was low. "Having other chronic conditions" was the risk factor for the HER2 positive breast cancer survivors to have higher QOL in the social life after treatment.
Tyrosine kinase inhibitors (TKIs) are the standard of care for non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutation. The efficacy of TKIs and prognosis of EGFR-mutated patients with compound EGFR mutation, oncogene mutation, suppresser gene mutation or other diver gene mutation are worse than those of patients with a single EGFR mutation. This article makes a review of related clinical researches aiming to provide references for clinical scenarios. To sum up, molecular alterations and clinical features should be correlated as accurately and dynamically as possible in the diagnostic and therapeutic process, and combined therapeutic strategies should be chosen flexibly and reasonably to improve patients’ survival and prognosis.
ObjectiveTo analyze the clinicopathologic features and prognosis of breast cancer patients with low human epidermal growth factor receptor-2 (HER2) expression. MethodsThe breast cancer patients underwent initially surgical resection in the First Hospital of Shanxi Medical University from October 2015 to October 2017 and met the criterion of this study were retrospectively gathered. Based on the immunohistochemical / in situ hybridization detection results, the patients were divided into three subtypes of HER2 zero, low, and positive expressions, and the differences in the clinicopathologic characteristics, overall survival (OS) and disease-free survival (DFS) of the three subtypes of breast cancer patients were compared. At the same time, the risk factors affecting the OS and DFS of breast cancer patients with low HER2 expression were analyzed. ResultsA total of 315 eligible patients were gathered in this study, including 68 patients with HER2 zero expression, 121 patients with low HER2 expression, and 126 patients with positive HER2 expression. There were no statistic differences in the menstrual status, T stage, and histological classification between the breast cancer patients with low HER2 and positive HER2 expressions (P>0.05), but the proportions of the patients with lymph node metastasis, histological grade Ⅲ, negative hormone receptor (HR) and high Ki67 expression in the low HER2 expression patients were lower than those in the positive HER2 expression patients. And compared with HER2 zero expression breast cancer patients, the proportions of premenopausal / perimenopausal, T2–4, N1–3, histological grade Ⅱ, ductal carcinoma, negative HR, and low Ki67 expression patients in the breast cancer patients with low HER2 expression were higher (P<0.05). While the survival curves of OS and DFS by Kaplan-Meier method had no statistic differences among the three subtypes of the breast cancer patients (χ2=0.070, P=0.966; χ2=0.362, P=0.835). The multivariate analysis results by Cox proportional hazards regression found that the low HER2 expression breast cancer patients with histological grade Ⅲ and negative HR had the higher risks of OS and DFS shortening (P<0.05). In addition, the risk of DFS shortening in the patients with T stage 2–4 and N stage 1–3 was increased (P<0.05). ConclusionsFrom the results of this study, breast cancer patients with low HER2 expression is different from the other two subtypes of breast cancer in terms of clinicopathologic characteristics. However, there are no statistical significances in comparing the OS and DFS of three types of breast cancer patients, but it is found that histological grading and HR are related to the OS and DFS of breast cancer patients with low HER2 expression, and it is also found that T stage and N stage are related to the DFS of breast cancer patients with low HER2 expression, so more attentions should be paid to the treatment plans.
ObjectiveTo summarize the biological characteristics of human epidermal growth factor receptor 2 (HER-2/neu) gene, the expression and meaning of HER-2/neu gene in gastric cancer, and clinical application of targeted medicine of HER-2/neu gene in gastric cancer.
MethodsRelated literatures about HER-2/neu gene and gastric cancer were retrieved for a review.
ResultsHER-2/neu gene encoded human epidermal growth factor receptor, and it participated in the gene regulation of tumor cell proliferation, invasion, and metastasis through the downstream signal transduction pathway. Amplification of HER-2/neu gene or overexpression of HER-2 was closely bound up to the occurrence and development of gastric cancer, however, whether it could be used as independent prognostic factors of gastric cancer remained to be controversial. Several targeted medicine of HER-2/neu gene had applied to clinical at present, and all of them obtained good short-term effect.
ConclusionHER-2/neu gene is a reliable target of gastric cancer and targeted medicine of HER-2/neu gene has a promising prospect.
Objective Investigate the effect and treatment prospects of urokinase-type plasminogen activator receptor（uPAR）in human epidermal growth factor receptor-2 （HER-2） positive breast cancer. Method Aricals related effect of uPAR in HER-2 positive breast caner were retrieved through Pubmed， and the role of uPAR was reviewed. Results uPAR played a very important role in the HER-2 positive breast cancer， anti-uPAR monomer or uPAR binding inhibitors could inhibit the growth， invasion and metastasis of breast cancer cells. Conclusion uPAR is one of the effective target for breast cancer， and it provides a new breakthrough in the treatment of HER-2 positive breast cancer.
