Effect of Differences in the Expression Levels Steroid Hormone Receptors and HER2 in the Primary Tumor and Metastatic Focus on the Efficacy of Eribulin Monotherapy in Metastatic Breast Cancer
Vol. 69 No. 4 (2023), ORIGINAL ARTICLES. C. CLINICAL RESEARCH
Vol. 69 No. 4 (2023)

Effect of Differences in the Expression Levels Steroid Hormone Receptors and HER2 in the Primary Tumor and Metastatic Focus on the Efficacy of Eribulin Monotherapy in Metastatic Breast Cancer

ORIGINAL ARTICLES. C. CLINICAL RESEARCH
https://doi.org/10.37469/0507-3758-2023-69-4-699-707
Published 02.09.2023
  • Anastasia Stukan+−
  • Roman Murashko
  • Svetlana Kutukova
  • Alla Goryainova
  • Виктория Антипова
Anastasia Stukan
онкодиспансер
https://orcid.org/0000-0002-0698-7710
Roman Murashko
https://orcid.org/0000-0001-8084-8770
Svetlana Kutukova
https://orcid.org/0000-0003-2221-4088
Alla Goryainova
https://orcid.org/0000-0001-7127-7945
Виктория Антипова
https://orcid.org/0000-0002-0006-3306
pdf (Русский)

Keywords

Eribulin
estrogen receptor
progesterone receptor
HER2 status

How to Cite

Stukan, A., Murashko , R., Kutukova , S., Goryainova, A., & Антипова, В. (2023). Effect of Differences in the Expression Levels Steroid Hormone Receptors and HER2 in the Primary Tumor and Metastatic Focus on the Efficacy of Eribulin Monotherapy in Metastatic Breast Cancer. Voprosy Onkologii, 69(4), 699–707. https://doi.org/10.37469/0507-3758-2023-69-4-699-707
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Abstract

Introduction. Currently, biopsy of metastatic focus is a crucial procedure for personalizing therapy in patients with metastatic breast cancer (mBC). Additionally, there is increasing evidence regarding the predictive and prognostic role of discordance in hormone receptors and human epidermal growth factor receptor 2 (HER2) status in mBC treatment.

Aim. To investigate the influence of variations in steroid hormone receptor and HER2 expression levels in the primary tumor and metastatic focus on the efficacy of Eribulin monotherapy in mBC.

Materials and Methods. The study conducted by the Oncology Department with Thoracic Surgery Course of the Faculty of Advanced Training and Retraining of Specialists of the Kuban State Medical University included patients with mBC (n = 61) who received Eribulin monotherapy at the Clinical Oncology Dispensary No. 1 in Krasnodar, Russia. Clinical data and outcomes were assessed according to medical records and the hospital cancer registry. The role of changes in steroid hormone receptor and HER2 expression in response to Eribulin monotherapy was analyzed.

Results. The study revealed that on Eribulin monotherapy, an ER expression > 50 % in the metastasis reduced progression-free survival (PFS) time (AUC 0.762 ± 0.092, 95 % CI (0.586-0.891), p = 0.0044). A decrease in Eribulin efficacy was observed in cases with HER2-0 the metastasis (AUC 0.750±0.144, 95 % CI (0.578-0.879), p = 0.0833).

PR expression ≤ 20 % (p = 0.0182, OR 0.14, 95 % CI 0.03-0.72) and HER2 3+ status (p = 0.0128) in the metastasis significantly increase PFS. The PFS median in patients with HER2 3+ status was not reached; at HER2-low (1+2+), it was 5 months, at HER2-0, it was 3 months (p = 0.0359, log-rank test). Predictive model decreasing PFS during Eribulin treatment included: ER>90% in the primary tumor, ER > 50 %, PR > 20 %, and HER2-0/low in the metastasis (AUC = 0.614 ± 0.092 (95 % CI 0.510-0.719), p = 0,0289). Thus, a luminal A HER2-negative status was described as an unfavorable surrogate phenotype in the metastatic focus for prescribing Eribulin monotherapy.

Conclusion. The presented data demonstrated the significant prognostic role of the discordance of steroid hormone receptor expression and HER2 status between the primary tumor and metastatic focus in the risk of progression on Eribulin monotherapy. It is evident that biopsy of the metastatic focus is an important factor capable of not only altering the treatment approach regarding the surrogate subtype of the metastatic focus but also personalizing chemotherapy in patients with metastatic breast cancer.

https://doi.org/10.37469/0507-3758-2023-69-4-699-707
pdf (Русский)

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