3000 person study-- her2+ early breast cancer divided into two groups by HR status

[Lani]

HR= hormone receptor

I think this study oversimplifies things. The good news is that ER+her2+ prognosis may be even better than previously believed.

I think ER+her2+ bc will be found to have important subgroup distinctions, but that is just my take on it



Breast Cancer Recurrence Defined by Hormone Receptor Status

Human epidermal growth factor (HER2) positive breast cancers are often treated with the same therapy regardless of hormone receptor status. New research published in the journal Breast Cancer Research shows that women whose HER2 positive cancer was also hormone (estrogen and progesterone) receptor (HR) negative had an increased risk of early death, and that their cancer was less likely to recur in bone than those whose cancer retained hormone sensitivity.

Breast cancer is a heterogeneous disease with many different subtypes. HR positive cancer is more likely to be luminal A or B type and be treated with endocrine therapy including tamoxifen or aromatase inhibitors, while HR negative cancer is more likely to be basal or 'HER2-enriched'. HER2 positive cancers can fall into both of these categories.

A multicenter study from 13 National Comprehensive Cancer Network (NCCN) hospitals analyzed data from over 3000 women diagnosed with early stage HER2 positive breast cancer. At first recurrence, most of the women in the study were treated with chemotherapy and/or with anti-HER2 therapy.

Dr. Ines Vaz-Luis, who led the study revealed, "In this large group of patients with HER2 positive breast cancer, we found significant associations between presence of HR and presenting features, patterns of recurrence and survival outcomes. In the first five years after treatment more women died from HR negative cancer than HR positive."

Recurrence in the brain or bone was also linked to receptor status, with more HR negative cancer in the brain and HR positive cancer in bone. About half of recurrent tumors tested had switched progesterone or estrogen receptor status (positive to negative or vice versa) or lost HER2 status during the study.

Vaz-Luis, continued, "Based on our findings, HR status defines two different subsets of HER2 positive cancers. To combat this, we believe that studies which look at new drugs for treating HER2-positive breast cancer should also integrate hormone receptor status into their design."

SOURCE:
Breast Cancer Research, October 1, 2012

[Hopeful]

I think the study showed that triple positive bc behaves more like HR+/Her2- bc, with later relapses and mets to the bone instead of visceral organs. The paper also said this:

"Concordant with previous knowledge, trastuzumab increases the rates of survival independently of HR status. After stratifying by adjuvant trastuzumab use, the differences in survival by HR status persisted. It is worth noting that despite a lower rate of pathologic complete responses (pCR) among patients with HR+/HER2+ tumors across neoadjuvant trials [10, 39-45], the overall prognosis of such patients is not worse than those with HR-/HER2+ tumors. These findings also suggest that in patients with HR+/HER2+ tumors, lack of pCR will, potentially, have less prognostic value than among patients with HR-/HER2+ tumors [46]."


Hopeful

[caya]

Thanks for keeping on top of this Lani.

I'm sure those of us who are HR+ as well as HER2+ are grateful to the research being done on our small subsect of BC.

And I keep reminding myself that WE are the statistics... my onc. told me in Dec. 2006, just after my mastectomy and before I began chemo in January 2007, that I would be the future of HER2+ statistics as they had only been giving Herceptin to early stagers for about a year in Canada...

Going on six years now, no recurrence for me!!

all the best
caya

[tricia keegan]

Thanks Lani, highly triple pos here and still waiting for the hammer to fall!!!!

[Laurel]

Tricia,

That hammer is NOT going to fall for you! Thanks Lani and Hopeful for the "hope!"

[michka]

Well, I am not the good example...and unfortunately on this forum I am not the only one. But this is not statistics. I believe like you Lani that it is more complicated than that. BUT Tricia, MOST of our HER2 sisters don't have metastasis! No hammer for you! Michka

[Ellie F]

Agree Lani that as time goes by we will find more subgroups for all including her2+/ ER-. My onc TOTALLY agrees with you, we discuss it each visit!

Ellie