Expression Patterns of Biomarkers in Primary Tumors and Corresponding Metastases in Breast Cancer
Tumor heterogeneity has been shown for several cancers including breast cancer (BC). Despite the fact that expression of tumor markers may change throughout the metastatic process, rebiopsies at the time of recurrence are still not performed routinely at all institutions. The aims of the study were to evaluate changes in biomarker profiles during the metastatic process and to investigate whether previous anthracycline or endocrine therapy given in the adjuvant setting could affect the biomarker profile in metastatic lesions. We investigated the expression pattern of ER, HER2, TOP2a, TOP1, p53, Bcl-2, and Ki-67 in 110 paired samples of primary BC and corresponding asynchronous metastases. We found discordant expressions in primary tumor and metastasis for all biomarkers, although only significant for Ki-67. Changes in the expression profile of the metastatic lesions would have altered treatment decisions in 14% of patients. We found no effect of previous anthracycline or endocrine therapy on the expression profiles. Our data confirm that discordant expressions of biomarkers are common in BC and often carry therapeutic consequences. This emphasizes the need for biopsies from metastatic lesions, even in cases where the localization of the metastatic process is not easily accessible.
This article reviews current endocrine treatment strategies and recent and ongoing studies of combination therapies in metastatic hormone receptor-positive, HER2-negative breast cancer. PMID: 30538108 [PubMed - in process]
Conclusion: ER+PR-HER2- breast cancer consists of clinically and genomically distinct groups that may require different treatment strategies. The non-luminal-like subgroup was associated with reduced benefit from endocrine therapy.
AbstractPurpose of ReviewMost women with hormone receptor (HR)-positive, HER2-negative (HR+/HER2 −) breast cancer will ultimately develop endocrine-resistant disease, either primary or acquired. This review will discuss the proposed mechanisms underlying endocrine resistance and key advances in the treatment of endocrine-resistant breast cancer.Recent FindingsEstrogen receptor 1 mutations (ESR1) occur in the majority of patients with HR+/HER2 − metastatic breast cancer after prolonged exposure to aromatase inhibitors. Data from the SoFEA trial showed that patients had improved progression-free survival (PFS) af...
Corsi D, Carbognin L, Mazzotta M, Bria E, Foglietta J, Samaritani R, Garufi C, Mariani L, Barni S, Mirabelli R, Sarmiento R, Graziano V, Santini D, Marchetti P, Tonini G, Di Lauro L, Sanguineti G, Paoletti G, Tomao S, De Maria R, Veltri E, Paris I, Giotta F, Latorre A, Giordano A, Ciliberto G, Vici P Abstract We carried out a retrospective observational study of 264 HER2-positive advanced breast cancer (ABC) patients to explore the efficacy of first-line treatment with pertuzumab/trastuzumab/taxane in real-world setting. Survival data were analyzed by Kaplan Meier curves and log rank test. Median follow-up, lengt...
Conclusion(s)The results for the overall population and Japanese patients in PALOMA-3 suggest that palbociclib plus fulvestrant was effective and well tolerated in Japanese patients with HR+/HER2 ‒ MBC whose disease had progressed on prior endocrine therapy (Pfizer; NCT01942135).
Condition: Breast Cancer Interventions: Biological: Pembrolizumab (K); Drug: Placebo (P); Drug: Paclitaxel (X); Drug: Doxorubicin hydrochloride (A); Drug: Epirubicin (E); Drug: Cyclophosphamide (C); Drug: Endocrine therapy; Radiation: Radiation therapy; Procedure: Surgery Sponsor: Merck Sharp & Dohme Corp. Not yet recruiting