Breast cancers with low levels of HER2 protein are not distinct subtypes of the disease, according to a study
There is no distinct subtype for breast cancers with low levels of the HER2 protein, according to new research
The introduction of drugs like trastuzumab (Herceptin) that target the HER2 protein has revolutionised the treatment of breast cancer. A new subtype of breast cancer with its own distinct behaviour and prognosis was suspected when researchers discovered that trastuzumab and chemotherapy drug conjugate often responded to breast cancer with lower levels of her2 than previously thought.
Researchers at Dana-Farber Cancer Institute have found that this is not the case. Data from over 5,000 patients showed that these "HER2-low" tumours were no different from "HER2-0" tumours, which lack or only have minute amounts of the HER2 protein, in their treatment response and long-term outcomes. JAMA Oncology is reporting the findings today.
For HER2-low and HER2-0 breast cancers, the results show that differences in their behaviour can be explained by the presence or absence of hormone receptors on the tumour cells, not by HER2.
Dana-Farber Cancer Institute's Susan F. Smith
At Dana-Farber Cancer Institute's Susan F. Smith Center for Women's Cancers in Boston, chief of the division of breast oncology and lead author on the study Sara Tolaney, MD, MPH, says that 80% of breast tumour samples were HER2-negative. "However, the expression of HER2 varies widely even within this group. HER2-low tumours have low levels of the protein, and HER2-0 tumours have no protein at all."
"The biology of HER2-low breast cancer is not well understood. We wanted to find out if HER2-low breast cancer is a distinct subtype of the disease "told me Tolaney.
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More than 5,000 HER2-negative breast cancer patients who had undergone surgery at Dana-Farber Brigham Cancer Center were studied. Researchers found that the pathologic complete response rate—the percentage of patients who had no signs of cancer after treatment—was essentially the same among patients with hormone receptor-positive (HR-positive) or triple-negative tumours, regardless of whether their tumours were HER2-low or HER2-0. Patients with HR-positive or triple-negative tumours had no differences in disease-free survival (the time during which cancer is undetectable) or overall survival between the HER2-low and HER2-0 groups, either.
HER2-low cancer cells
HER2-low cancer cells had a positive correlation between the abundance of oestrogen receptors and the production of HER2 proteins, according to the results of the analysis.
Research led by Paolo Tarantino, MD, of Dana-Farber Cancer Institute, European Institute of Oncology, and the University of Milan shows no significant differences between breast cancers that are low in HER or high in HER, according to Tarantino. "As a result, HER2-low breast cancer tumours should not be considered a distinct biological subtype of breast cancer. We hope to see the benefits of novel anti-HER2 conjugates extend beyond HER2-low tumours to include patients with tumours currently defined as HER2-0 in the future."
News Source: https://medicalxpress.com/news/2022-06-breast-cancers-her2-protein-distinct.html
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