Journal
BREAST CANCER RESEARCH AND TREATMENT
Volume 191, Issue 1, Pages 1-14Publisher
SPRINGER
DOI: 10.1007/s10549-021-06390-6
Keywords
Breast cancer; Receptor discordance; Estrogen receptor; Progesterone receptor; Human epidermal growth factor receptor 2; Prognosis
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Funding
- Japan Society for the Promotion of Science (JSPS) Overseas Challenge Program for Young Researchers
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This meta-analysis revealed that loss of ER or PR in recurrent tumors was significantly associated with shorter overall survival. Similar trends were observed in groups with distant metastasis. Gain of ER was a significant predictor of longer post-recurrence survival.
Purpose This meta-analysis aimed to investigate whether receptor (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]) discordances between primary and recurrent breast cancers affect patients' survival. Methods Search terms contained ER, PR, and HER2 status details in both primary and recurrent tumors (local recurrence or distant metastasis) in addition to survival outcome data (overall survival [OS] or post-recurrence survival [PRS]). Results Loss of ER or PR in recurrent tumors was significantly associated with shorter OS as compared with receptor-positive concordance (hazard ratio [HR], 1.67; 95% confidence interval [% CI] 1.37-2.04; p < 0.00001 and HR, 1.45; 95% CI 1.21-1.75; p < 0.0001, respectively). Similar trends were observed in groups with only distant metastasis. Gain of ER was a significant predictor of longer PRS as compared with receptor-negative concordance (HR, 0.76; 95% CI 0.59-0.97; p = 0.03). Gain of PR was not a significant predictor of longer survival compared with receptor-negative concordance, but it could be related to better OS at distant metastasis. Both HER2 of loss and gain could be related to poor outcomes. Conclusion This meta-analysis showed that receptor conversion in recurrent tumors may affect patient survival as compared with receptor concordance.
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