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Ann Oncol: The prognosis of patients with hormone receptor (HR) low-positive breast cancer: Based on the results of a 15-year population cohort study

 Last Update: 2021-11-12
 Source: Internet
 Author: User

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Hormone receptor (HR) status, including estrogen receptor (ER) and progesterone receptor (PR), is one of the most important prognostic and predictive factors for breast cancer
.

A typical HR positive is defined as nuclear staining of at least 10% of tumor epithelial cells

Hormone receptor (HR) status, including estrogen receptor (ER) and progesterone receptor (PR), is one of the most important prognostic and predictive factors for breast cancer

The study endpoints were time to local recurrence (TTLR), time to lymph node recurrence (TTLNR), time to metastasis (TTM), overall survival time (OS) and relative survival time (RS)
.

The study endpoints were time
to local recurrence (TTLR), time to lymph node recurrence (TTLNR), time to metastasis (TTM), overall survival time (OS) and relative survival time (RS) .

Time to local recurrence (TTLR), time to lymph node recurrence (TTLNR), time to metastasis (TTM), overall survival time (OS) and relative survival time (RS)

This population cohort included 38560 female patients diagnosed with early invasive breast cancer between 2004 and 2018 , of which 861 were low-positive HR (2%), 4862 were HR-negative (13%), and 32,837 were HR-strongly-positive (85%).

TTLR

The median follow-up time was 71 months (range 0-185 months)
.

In order to consider the difference in treatment indications, survival analysis was performed on HER2-positive and HER2-negative tumors

The median follow-up time was 71 months (range 0-185 months)

TTLNR

The same is true for TTLNR and TTM.
In the HER2-negative subgroup, HR low-positive and HR-strongly positive tumor curves are significantly different; in the HER2-positive subgroup, there is only a slight difference
.

The same is true for TTLNR and TTM.

TTM

In the HER2-negative subgroup (n = 33 366), the 10-year OS was 66% for HR-negative patients, 65% for HR-negative patients, and 75% for HR-positive patients
.

The survival rate of patients with low HR positive tumors was significantly worse than that of strong HR positive tumors [OS: HR=0.

In the HER2-negative subgroup (n = 33 366), the 10-year OS was 66% for HR-negative patients, 65% for HR-negative patients, and 75% for HR-positive patients

OS and RS

47% of HER2-negative/low-HR-positive patients and 42% of HER2-positive/low-HR-positive patients received endocrine therapy
.

To evaluate the effect of endocrine therapy on patients with low HR-positive tumors, the study performed additional survival analysis

47% of HER2-negative/low-HR-positive patients and 42% of HER2-positive/low-HR-positive patients received endocrine therapy
.
To evaluate the effect of endocrine therapy on patients with low HR-positive tumors, the study performed additional survival analysis
.
In HER2-negative/low-HR-positive patients, the Kaplan-Meier curve showed a slight benefit from endocrine therapy, but this effect was not statistically significant.
The adjusted hazard ratio was 0.
78 (95% CI 0.
55-1.
11)
.
However, in HER2-negative/HR strongly-positive patients, this difference in survival was greater and statistically significant, and the final adjusted hazard ratio was 0.
73 (95% CI 0.
68-0.
78)
.
Similar results can be seen in HER2-positive patients
.
In short, regardless of HER2 status, patients with low HR positive cannot benefit from endocrine therapy
.
47% of HER2-negative/low-HR-positive patients and 42% of HER2-positive/low-HR-positive patients received endocrine therapy
.
To evaluate the effect of endocrine therapy on patients with low HR-positive tumors, the study performed additional survival analysis
.
In HER2-negative/low-HR-positive patients, the Kaplan-Meier curve showed a slight benefit from endocrine therapy, but this effect was not statistically significant.
The adjusted hazard ratio was 0.
78 (95% CI 0.
55-1.
11)
.
However, in HER2-negative/HR strongly-positive patients, this difference in survival was greater and statistically significant, and the final adjusted hazard ratio was 0.
73 (95% CI 0.
68-0.
78)
.
Similar results can be seen in HER2-positive patients
.
In short, regardless of HER2 status, patients with low HR positive cannot benefit from endocrine therapy
.

The effect of endocrine therapy on OS and RS

In summary, research shows that the current definition of HR positive and its clinical relevance should be reconsidered
.
Patients with low-HR/HER2-negative tumors should be treated the same as patients with triple-negative tumors
.
Studies have shown that the current definition of HR positive and its clinical relevance should be reconsidered
.
Patients with low-HR/HER2-negative tumors should be treated the same as patients with triple-negative tumors
.
Studies have shown that the current definition of HR positive and its clinical relevance should be reconsidered
.
Patients with low-HR/HER2-negative tumors should be treated the same as patients with triple-negative tumors
.

Original source:

Schrodi S, Braun M, Andrulat A, Harbeck N, Mahner S, Kiechle M, Klein E, Schnelzer A, Schindlbeck C, Bauerfeind I, Schubert-Fritschle G, Nekljudova V, Mayr D, Weichert W, Denkert C, Loibl S, Engel J.
Outcome of breast cancer patients with low hormone receptor positivity: analysis of a 15-year population-based cohort.
Ann Oncol.
2021 Nov;32(11):1410-1424.
doi: 10.
1016/j.
annonc.
2021.
08.
1988.
Epub 2021 Aug 20.
PMID: 34419555.

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