Asunto(s)
Humanos , Femenino , Pronóstico , Receptor ErbB-2 , Neoplasias de la Mama Triple NegativasRESUMEN
Introdução: Os tumores triplo-negativos representam cerca de 15% dos casos de câncer de mama. Apesar dos avanços significativos em termos de tratamento, a busca por biomarcadores alvo na doença triplo-negativa ainda se mostra necessária, devido a seu perfil de evolução desfavorável e comportamento agressivo. O estudo DESTINY-Breast04 demonstrou a atividade antitumoral do Trastuzumabe-Deruxtecan no cenário de tumores com expressão baixa a moderada do já conhecido receptor HER2. Estudos realizados no cenário de doença inicial e avançada encontraram resultados controversos quanto à real implicação clínica e prognóstica de tumores HER2-zero e HER2-low. Objetivos: Avaliar o prognóstico, em 60 meses, e as características clinicopatológicas entre as diferentes expressões de HER2 no câncer primário de mama triplo-negativo em estádios I a III. Métodos: Coorte retrospectiva de mulheres com diagnóstico de câncer de mama triplo-negativo em estágio inicial, que receberam tratamento com cirurgia e quimioterapia no Instituto Nacional do Câncer entre 2010 e 2016. Os dados coletados abordaram aspectos da paciente, do tumor, dos tratamentos aplicados e da progressão da doença. Resultado: Foram avaliadas 512 pacientes com câncer de mama triplo-negativo, em que 44,9% tinham expressão de HER2 zero, 44,1% score 1+/3+, e 10,9% score 2+/3+. A média de idade foi de 51 anos. Não houve diferença significativa ao comparar as características sociodemográficas, clínicas e patológicas entre os subgrupos de HER2. Também não foi encontrada diferença em termos de resposta patológica completa, sobrevida livre de recidiva e sobrevida global em 60 meses. Conclusão: Os resultados deste estudo sugerem que as diferentes expressões de HER2 no câncer de mama triplo-negativo em estágio inicial não possuem desfechos clínicos e prognósticos distintos
Introduction: Triple-negative breast cancer accounts for about 15% of all breast cancer cases. Despite significant advances in terms of treatment, the search for targetable biomarkers in the triple negative disease is still necessary, considering its unfavorable evolution and aggressive behavior. The DESTINY-Breast04 study was able to elucidate an opportunity of targeted treatment for these patients by demonstrating the antitumor activity of Trastuzumab-Deruxtecan in the scenario of low to moderate expression of the known HER2 receptor. Studies carried out in the setting of initial and advanced disease have found controversial results regarding the real clinical and prognostic implications between HER2-zero and HER2-low subgroups. Objective: To evaluate the 60-month prognosis and clinicopathological characteristics of different HER2 expressions in primary triple-negative breast cancer in stages I to III. Methods: Retrospective cohort of women diagnosed with early stage triple negative breast cancer who underwent surgery and chemotherapy in a single Brazilian institution from 2010 to 2016. The data collected addressed demographic aspects of the patient, tumor features, the applied treatments and the progression of the disease. Tumors were defined as HER2-low if they had a HER2 immunohistochemistry score of 1+ or 2+ with negative in situ hybridization and HER2-zero if they had a HER2 score of 0. Results: A total of 512 cases were evaluated, in which 44.9% had HER2-zero tumors, 44.1% had HER2 immunohistochemistry score of 1+/3+, and 10.9% of 2+/3+. The mean age was 51 years. There was no significant difference when comparing sociodemographic, clinical and pathological characteristics between HER2 subgroups. Also, no statistically significant difference was found in terms of complete pathological response, relapse-free survival, site of relapse, and overall 60-month survival. Conclusion: The results of this study suggest that the clinical behavior and prognosis of the different expressions of HER2 in the early-stage triple-negative breast cancer do not differ significantly
