[PDF] Anticipating changes in the HER2 status of breast tumours with disease progression—towards better treatment decisions in the new era of HER2-low breast cancers | Semantic Scholar (2024)

There is a possibility of HER2 expression alteration in the metastases of HER2-low breast cancer, and the rate of altered HER2 low expression was different among different metastatic sites, different T stages of primary BC and specimen type of metastasis.

Receptor discordance between primary tumor and synchronous axillary lymph node metastasis appears to already exist before any anti-tumor therapy, and this instability has limited clinical impact on the choice of neoadjuvant therapy at current stage.

Multidisciplinary joint efforts and pro-active discussions between clinicians and decision makers are needed to improve care of HER2-low mBC patients in CEE countries.

Tailoring of subsequent treatment strategy seems to be essential for achieving long-term benefit after CDK4/6i progression, especially in cases affecting the central nervous system.

The potential role of artificial intelligence (AI) in the field of digital pathology and its integration into HER2 testing, with a particular emphasis on its application in the context of HER2-low breast cancer is considered.

This review summarizes the mechanisms of resistance to ET and CDK4/6i, which can be broadly classified as alterations affecting cell cycle mediators and activation of alternative signaling pathways, and describes the findings from recent clinical trials using small molecule inhibitors, antibody–drug conjugates and immunotherapy.

The opportunities and challenges of using mRNA–LNPs in oncology applications are described and the challenges for successfully translating the findings of preclinical studies of these nanoparticles into the clinic are discussed, considering physiological, technological and manufacturing challenges.

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The main aim of this study is to describe the evolution of HER2 expression from primary BC to relapse by including HER2-low category in both primary and recurrent BC samples, which is highly unstable during disease evolution.

It is demonstrated that Her2-low tumors could be identified as a more distinct clinical entity from HER2-zero tumors, especially for the HR-positive subgroup, thus offering new therapeutic targets for breast cancer treatment.

The large biological heterogeneity of HER2-low BC is emphasized, and the need to implement reproducible and sensitive assays to measure low HER2 expression is emphasized.

ERBB2 FISH analysis of cellular heterogeneity identified the fraction of ERBB2 non-amplified cells as a driver of therapeutic resistance, suggesting HER2 heterogeneity is associated with resistance to HER2-targeted therapy and should be considered in efforts to optimize treatment strategies.

The benefit of adjuvant trastuzumab persists for a long time, particularly in patients with N0 or N1 disease, and a distinct pattern of recurrence was observed between HR+ and HR- HER2+ disease but with similar degree of benefit from adjuants.

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