Clinico-pathological predictors of radiologic complete response to first-line anti-HER2 therapy in metastatic breast cancer

Linda Cucciniello; Eva Blondeaux; Claudia Bighin; Simona Gasparro; Stefania Russo; Arianna Dri; Palma Pugliese; Andrea Fontana; Enrico Cortesi; Antonella Ferzi; Ferdinando Riccardi; Valentina Sini; Luca Boni; Alessandra Fabi; Filippo Montemurro; Michelino De Laurentiis; Grazia Arpino; Lucia Del Mastro; Lorenzo Gerratana; Fabio Puglisi

doi:10.1038/s41523-024-00713-8

Clinico-pathological predictors of radiologic complete response to first-line anti-HER2 therapy in metastatic breast cancer

NPJ Breast Cancer. 2024 Dec 18;10(1):105. doi: 10.1038/s41523-024-00713-8.

Authors

Linda Cucciniello^{1

2}, Eva Blondeaux³, Claudia Bighin⁴, Simona Gasparro⁵, Stefania Russo⁶, Arianna Dri^{1

2}, Palma Pugliese⁷, Andrea Fontana⁸, Enrico Cortesi⁹, Antonella Ferzi¹⁰, Ferdinando Riccardi¹¹, Valentina Sini¹², Luca Boni³, Alessandra Fabi^{5

13}, Filippo Montemurro^{14

15}, Michelino De Laurentiis¹⁶, Grazia Arpino¹⁷, Lucia Del Mastro^{4

18}, Lorenzo Gerratana^#^{19

20}, Fabio Puglisi^#^{1

2}

Affiliations

¹ Department of Medicine, University of Udine, 33100, Udine, Italy.
² Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy.
³ U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
⁴ Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.
⁵ Medical Oncology 1, IRCSS Regina Elena National Cancer Institute, Rome, Italy.
⁶ Department of Oncology, Santa Maria della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100, Udine, Italy.
⁷ Unit of Oncology, Department of Medical, ASST Lariana, Como, Italy.
⁸ Unit of Oncology 2, Department of Medical and Oncological Area, Pisa University Hospital, 56126, Pisa, Italy.
⁹ Department of Radiology, Pathology and Oncology, La Sapienza University, Rome, Italy.
¹⁰ Medical Oncology, ASST Ovest Milanese, Ospedale di Legnano, Legnano, Italy.
¹¹ Oncology Unit, Antonio Cardarelli Hospital, Naples, Italy.
¹² U.O. Centro Oncologico S. Spirito-Nuovo Regina Margherita, ASL Roma 1, Rome, Italy.
¹³ Unit of Precision Medicine in Breast Cancer, Scientific Directorate, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168, Rome, Italy.
¹⁴ Gynecological Oncology Unit, Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy.
¹⁵ Multidisciplinary Outpatient Oncology Clinic, Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy.
¹⁶ Breast Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Via Mariano Semmola 53, 80131, Napoli, Italy.
¹⁷ Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
¹⁸ Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
¹⁹ Department of Medicine, University of Udine, 33100, Udine, Italy. lorenzo.gerratana@outlook.com.
²⁰ Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy. lorenzo.gerratana@outlook.com.

^# Contributed equally.

Abstract

This study aimed to identify the clinico-pathological variables predictive of radiologic complete response (rCR) to first-line anti-HER2 therapy in patients with HER2-positive metastatic breast cancer. Patients were selected from the database of the GIM14 study and classified according to the best radiologic response obtained to first-line anti-HER2 therapy and upon time-to-treatment-discontinuation (TTD). A total of 545 patients were included in the analysis. Eighty patients experienced a rCR to first-line anti-HER2 therapy with a TTD > 3 months and HER2 Immunohistochemistry score 3+, presence of non-visceral metastases and 1 metastatic site were significantly associated with higher odds of obtaining a CR. Of the 80 patients achieving a rCR, 56 experienced a CR with a TTD > 18 months, with anti-HER2 therapy being the only variable significantly associated with a higher probability of achieving such sustained CR.