Receptor Conversion in Distant Breast Cancer Metastases: A Systematic Review and Meta-analysis.
Willemijne A. M. E. Schrijver,Karijn P M Suijkerbuijk,Carla H. van Gils,Elsken van der Wall,Cathy B. Moelans,Paul J. van Diest +5 more
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TLDR
Receptor conversion for ERα, PR, and HER2 occurs frequently in the course of disease progression in breast cancer, and large prospective studies assessing the impact of receptor conversion on treatment efficacy and survival are needed.Abstract:
Background: In metastatic breast cancer, hormone and/or human epidermal growth factor receptor 2 (HER2)-targeted therapy decision-making is still largely based on tissue characteristics of the primary tumor. However, a change of estrogen receptor alpha (ERa), progesterone receptor (PR), and HER2 status in distant metastases has frequently been reported. The actual incidence of this phenomenon has been debated. Methods: We performed a meta-analysis including 39 studies assessing receptor conversion from primary breast tumors to paired distant breast cancer metastases. We noted the direction of change (positive to negative or vice versa) and performed subgroup analyses for different thresholds for positivity, the type of test used to assess HER2 receptor status, and metastasis location-specific differences (two-sided tests). Results: Overall, the incidence of receptor conversion varied largely between studies. For ERa, PR, and HER2, we found that random effects pooled positive to negative conversion percentages of 22.5% (95% confidence interval [CI] ¼ 16.4% to 30.0%), 49.4% (95% CI ¼ 40.5% to 58.2%), and 21.3% (95% CI ¼ 14.3% to 30.5%), respectively. Negative to positive conversion percentages were 21.5% (95% CI ¼ 18.1% to 25.5%), 15.9% (95% CI ¼ 11.3% to 22.0%), and 9.5% (95% CI ¼ 7.4% to 12.1%). Furthermore, ERa discordance was statistically significantly higher in the central nervous system and bone compared with liver metastases (20.8%, 95% CI ¼ 15.0% to 28.0%, and 29.3%, 95% CI ¼ 13.0% to 53.5%, vs 14.3%, 95% CI ¼ 11.3% to 18.1, P ¼ .008 and P < .001, respectively), and PR discordance was higher in bone (42.7%, 95% CI ¼ 35.1% to 50.6%, P < .001) and liver metastases (47.0%, 95% CI ¼ 41.0% to 53.0%, P < .001) compared with central nervous system metastases (23.3%, 95% CI ¼ 16.0% to 32.6%). Conclusions: Receptor conversion for ERa, PR, and HER2 occurs frequently in the course of disease progression in breast cancer. Large prospective studies assessing the impact of receptor conversion on treatment efficacy and survival are needed. Meanwhile, reassessing receptor status in metastases is strongly encouraged.read more
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Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study
TL;DR: Both HER2+ and HR+/HER2+ subtypes were significantly associated with higher rates of liver, brain, and lung metastases, while the highest OR was observed in liver metastases.
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HER2 Testing by Local, Central, and Reference Laboratories in Specimens From the North Central Cancer Treatment Group N9831 Intergroup Adjuvant Trial
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HER2 status in breast cancer: changes in guidelines and complicating factors for interpretation.
TL;DR: This review addresses recent updates of ASCO/CAP guidelines and factors complicating in the interpretation of HER2 status in breast cancers.
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Focus on the glycerophosphocholine pathway in choline phospholipid metabolism of cancer.
Kanchan Sonkar,Vinay Ayyappan,Caitlin M. Tressler,Oluwatobi Adelaja,Ruoqing Cai,Menglin Cheng,Kristine Glunde +6 more
TL;DR: This review article summarizes the recent literature on glycerophosphocholine metabolism with respect to its cancer biology and its detection by magnetic resonance spectroscopy applications.
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Subtype switching in breast cancer brain metastases: a multicenter analysis.
Alexander F. C. Hulsbergen,Alexander F. C. Hulsbergen,Alexander F. C. Hulsbergen,An Claes,Vasileios K. Kavouridis,Ali Ansaripour,Claudine O. Nogarede,Melissa E. Hughes,Timothy R. Smith,Priscilla K. Brastianos,Joost J.C. Verhoeff,Nan Lin,Marike L. D. Broekman,Marike L. D. Broekman,Marike L. D. Broekman +14 more
TL;DR: In this multicenter study, incidence and predictors of subtype switching, the risk of which varies considerably by baseline subtype, can have clinical implications for prognosis and treatment choice.
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TL;DR: The QUADAS-2 tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.
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