Background: Loss of HER2 "positivity" can occur in patients with residual disease after neoadjuvant treatment, but the incidence of HER2-positivity loss after neoadjuvant dual HER2-targeted treatment plus chemotherapy, the current standard-of-care for most early stage HER2-positive breast cancers, is not well described. Previous studies that report the HER2 discordance rate after neoadjuvant treatment also do not include the novel HER2-low category. In this retrospective study, we determine the incidence and prognostic impact of HER2-positivity loss, including the evolution to HER2-low disease, after neoadjuvant dual HER2-targeted therapy with chemotherapy.
Methods: Clinicopathologic data for patients with stage I-III HER2+ breast cancer diagnosed between 2015 and 2019 were reviewed in this single institution retrospective study. Patients who received dual HER2-targeted treatment with chemotherapy were included, and HER2 status before and after neoadjuvant therapy was interrogated.
Results: A total of 163 female patients were included in the analysis with a median age of 50 years. A pathologic complete response (pCR as defined by ypT0/is) was achieved in 102 (62.5%) of 163 evaluable patients. Among the 61 patients with residual disease after neoadjuvant therapy, 36 (59.0%) had HER2-positive and 25 (41.0%) had HER2-negative residual disease. Of the 25 patients with HER2-negative residual disease, 22 (88%) of patients were classified as HER2-low. After a median follow-up of 3.3 years, patients who retained HER2-positivity after neoadjuvant treatment had a 3-year IDFS rate of 91% (95% CI, 91%-100%), while patients who lost HER2-positivity had a 3-year IDFS rate of 82% (95% CI, 67%-100%).
Conclusion: Almost half of patients with residual disease following neoadjuvant dual HER2-targeted therapy plus chemotherapy lost HER2-positivity. The loss of HER2-positivity may not confer negative prognostic impact, although the results were limited by short follow-up time. Further research on the HER2 status after neoadjuvant treatment may help guide treatment decisions in the adjuvant setting.
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http://dx.doi.org/10.1002/cam4.5817 | DOI Listing |
J Bone Miner Res
January 2025
Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan.
This study analyzed the association of romosozumab, a human monoclonal antibody with bone-forming and bone resorption-inhibiting effects, and bisphosphonates with the development of cardiovascular disease among patients with osteoporosis. A new-user design was employed to address selection bias, and instrumental variable analysis was used to address confounding by indication. Japanese patients aged ≥40 years, diagnosed with osteoporosis or experienced a fragility fracture, were admitted to medical facilities covered by a commercial administrative claims database, and newly prescribed romosozumab or bisphosphonates after the commercialization of romosozumab in Japan (March 4, 2019) were included based on verification of a 180-day washout period.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Cardiology Department, Schoen Hospital Neustadt, Holstein, Germany.
Primary cardiac tumors are a rare disease, with 20% of the cases being malignant. Among them, angiosarcoma is characterized by a short clinical course and poor prognosis, even after surgery, chemotherapy, and radiation therapy. We present a 67-year-old woman diagnosed with a primary malignant tumor (angiosarcoma) infiltrating the right atrial myocardium.
View Article and Find Full Text PDFKidney Med
November 2024
Department of Medicine, University of Illinois Chicago, Chicago, IL.
Rationale & Objective: In the general population, neighborhood socioeconomic status (SES) has been found to be associated with cardiovascular risk, but this relationship has not been well studied among patients with chronic kidney disease (CKD). This study seeked to evaluate the association between neighborhood SES and cardiovascular outcomes in a CKD cohort.
Study Design: Multicenter prospective cohort.
Am J Transl Res
December 2024
Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Tianjin 300060, China.
Objective: To investigate the clinical effect of Almonertinib in in patients with epidermal growth factor receptor (EGFR) mutation-positive residual ground-glass opacities following resection of stage I lung cancer.
Methods: A retrospective analysis of 75 patients with EGFR mutation-positive residual ground-glass opacities post-stage I lung cancer surgery was conducted at Tianjin Medical University Cancer Institute and Hospital between January 2021 and December 2023. Patients were categorized into the control group (CG, n = 33, treated with pemetrexed and cisplatin) and the observation group (OG, n = 42, treated with Almonertinib).
Open Forum Infect Dis
January 2025
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Background: Understanding the risk of hospitalization from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can guide effective public health interventions and severity assessments. This study calculated infection-hospitalization ratios (IHRs) and infection-case ratios (ICRs) to understand the relationship between SARS-CoV-2 infections, cases, and hospitalizations among different age groups during periods of Delta and Omicron variant predominance.
Methods: After calculating antinucleocapsid SARS-CoV-2 antibody seroprevalence using residual commercial laboratory serum specimens, 2 ratios were computed: (1) IHRs using coronavirus disease 2019 hospitalization data and (2) ICRs using Centers for Disease Control and Prevention surveillance data.
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