Title Prognostic Value of Plasma HER2 Gene Copy Number in HER2-Positive Metastatic Breast Cancer Treated with First-Line Trastuzumab
Authors Ran, Ran
Huang, Wenfa
Liu, Yaxin
Shao, Lin
Liu, Xiaoran
Niu, Yunyun
Kong, Weiyao
Bo, Shiping
Rugo, Hope S.
Lu, Sijia
Li, Huiping
Affiliation Peking Univ, Dept Breast Oncol, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing,Canc Hosp & Inst, Beijing 100142, Peoples R China
Yikon Genom Co Ltd, Dept Clin Res, Shanghai, Peoples R China
Univ Calif San Francisco, Helen Diller Family Comp, San Francisco, CA 94143 USA
Keywords CIRCULATING TUMOR DNA
CELL-FREE DNA
ADJUVANT CHEMOTHERAPY
AMPLIFICATION
SURVIVAL
THERAPY
PLUS
EFFICACY
LEVEL
HYBRIDIZATION
Issue Date 2020
Publisher ONCOTARGETS AND THERAPY
Abstract Objective: Patients with HER2-positive metastatic breast cancer (MBC) benefit from trastuzumab-based therapy but eventually develop intrinsic or acquired resistance. Whether plasma HER2 gene copy number (GCN) could predict survival after trastuzumab treatment remained controversial. We evaluated the prognostic value of plasma HER2 GCN using low-coverage whole-genome sequencing (LC-WGS). Methods: The plasma was collected from HER2-positive MBC patients whose pre-therapeutic samples were available before first-line trastuzumab-based treatment. Plasma DNA was extracted and assessed by LC-WGS for HER2 GCN. The optimal cut-off point for HER2 GCN to shorter survival was determined by receiver operating characteristic (ROC) curve analysis. Results: A total of 49 patients were retrieved from 2013 to 2017, among whom 21 had multiple organ involvement (>= 3 sites). Variations of HER2 GCN in pre-therapeutic plasma ranged from 1.89 to 23.86 (median = 2.59). ROC analysis identified the optimal cut-off point for HER2 GCN as 2.82 (P = 0.005), with 23 patients had high-level HER2 GCN and 26 in the low-level group. Both progression-free survival (PFS, P = 0.032) and overall survival (OS, P = 0.006) were adversely associated with high-level HER2 GCN. In multivariate analyses, high HER2 GCN was independently associated with shorter PFS [hazard ratio (HR) = 2.042, P = 0.037], while both high HER2 GCN (HR = 4.909, P = 0.004) and more metastatic organs (HR = 4.019, P = 0.011) were negative prognostic factors for OS. Conclusion: In this population of patients with HER2-positive MBC, individuals with high HER2 GCNs in plasma had worse prognosis after trastuzumab-based therapy. Plasma HER2 GCN may be a prognostic marker in these patients.
URI http://hdl.handle.net/20.500.11897/589014
ISSN 1178-6930
DOI 10.2147/OTT.S240990
Indexed SCI(E)
Appears in Collections: 北京肿瘤医院

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