Abstract
Background The discordance in oestrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) status between primary and recurrent breast cancer is being intensively investigated and a large amount of data have been produced. However, results from different studies are heterogeneous and often conflicting. To highlight this issue, a meta-analysis of published data was performed. Methods A literature search was performed using Medline, and all the studies published from 1983 to 2011 comparing changes in ER, PgR and/or HER2 status in patients with matched breast primary and recurrent tumours were included. We used random-effects models to estimate pooled discordance proportions. Results We selected 48 articles, mostly reporting retrospective studies. Thirty-three, 24 and 31 articles were focused on ER, PgR and HER2 changes, respectively. A total of 4200, 2739 and 2987 tumours were evaluated for ER, PgR and HER2 discordance, respectively. The heterogeneity between study-specific discordance proportions was high for ER (I2 = 91%, p <0.0001), PgR (I2 = 79%, p <0.0001) and HER2 (I2 = 77%, p <0.0001). Pooled discordance proportions were 20% (95% confidence interval (CI): 16-35%) for ER, 33% (95% CI: 29-38%) for PgR and 8% (95% CI: 6-10%) for HER2. Pooled proportions of tumours shifting from positive to negative and from negative to positive were 24% and 14% for ER (p = 0.0183), respectively. The same figures were 46% and 15% for PgR (p <0.0001), and 13% and 5% for HER2 (p = 0.0004). Conclusion Our findings strengthen the concept that changes in receptor expression may occur during the natural history of breast cancer, suggesting clinical implications and a possible impact on treatment choice.
| Original language | English |
|---|---|
| Pages (from-to) | 277-289 |
| Number of pages | 13 |
| Journal | European Journal of Cancer |
| Volume | 50 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jan 2014 |
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Keywords
- Breast cancer
- Concordance
- HER2
- Hormone receptors
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
A meta-analysis of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 discordance between primary breast cancer and metastases. / Aurilio, Gaetano; Disalvatore, Davide; Pruneri, Giancarlo; Bagnardi, Vincenzo; Viale, Giuseppe; Curigliano, Giuseppe; Adamoli, Laura; Munzone, Elisabetta; Sciandivasci, Angela; De Vita, Fernando; Goldhirsch, Aron; Nolè, Franco.
In: European Journal of Cancer, Vol. 50, No. 2, 01.2014, p. 277-289.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A meta-analysis of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 discordance between primary breast cancer and metastases
AU - Aurilio, Gaetano
AU - Disalvatore, Davide
AU - Pruneri, Giancarlo
AU - Bagnardi, Vincenzo
AU - Viale, Giuseppe
AU - Curigliano, Giuseppe
AU - Adamoli, Laura
AU - Munzone, Elisabetta
AU - Sciandivasci, Angela
AU - De Vita, Fernando
AU - Goldhirsch, Aron
AU - Nolè, Franco
PY - 2014/1
Y1 - 2014/1
N2 - Background The discordance in oestrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) status between primary and recurrent breast cancer is being intensively investigated and a large amount of data have been produced. However, results from different studies are heterogeneous and often conflicting. To highlight this issue, a meta-analysis of published data was performed. Methods A literature search was performed using Medline, and all the studies published from 1983 to 2011 comparing changes in ER, PgR and/or HER2 status in patients with matched breast primary and recurrent tumours were included. We used random-effects models to estimate pooled discordance proportions. Results We selected 48 articles, mostly reporting retrospective studies. Thirty-three, 24 and 31 articles were focused on ER, PgR and HER2 changes, respectively. A total of 4200, 2739 and 2987 tumours were evaluated for ER, PgR and HER2 discordance, respectively. The heterogeneity between study-specific discordance proportions was high for ER (I2 = 91%, p <0.0001), PgR (I2 = 79%, p <0.0001) and HER2 (I2 = 77%, p <0.0001). Pooled discordance proportions were 20% (95% confidence interval (CI): 16-35%) for ER, 33% (95% CI: 29-38%) for PgR and 8% (95% CI: 6-10%) for HER2. Pooled proportions of tumours shifting from positive to negative and from negative to positive were 24% and 14% for ER (p = 0.0183), respectively. The same figures were 46% and 15% for PgR (p <0.0001), and 13% and 5% for HER2 (p = 0.0004). Conclusion Our findings strengthen the concept that changes in receptor expression may occur during the natural history of breast cancer, suggesting clinical implications and a possible impact on treatment choice.
AB - Background The discordance in oestrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) status between primary and recurrent breast cancer is being intensively investigated and a large amount of data have been produced. However, results from different studies are heterogeneous and often conflicting. To highlight this issue, a meta-analysis of published data was performed. Methods A literature search was performed using Medline, and all the studies published from 1983 to 2011 comparing changes in ER, PgR and/or HER2 status in patients with matched breast primary and recurrent tumours were included. We used random-effects models to estimate pooled discordance proportions. Results We selected 48 articles, mostly reporting retrospective studies. Thirty-three, 24 and 31 articles were focused on ER, PgR and HER2 changes, respectively. A total of 4200, 2739 and 2987 tumours were evaluated for ER, PgR and HER2 discordance, respectively. The heterogeneity between study-specific discordance proportions was high for ER (I2 = 91%, p <0.0001), PgR (I2 = 79%, p <0.0001) and HER2 (I2 = 77%, p <0.0001). Pooled discordance proportions were 20% (95% confidence interval (CI): 16-35%) for ER, 33% (95% CI: 29-38%) for PgR and 8% (95% CI: 6-10%) for HER2. Pooled proportions of tumours shifting from positive to negative and from negative to positive were 24% and 14% for ER (p = 0.0183), respectively. The same figures were 46% and 15% for PgR (p <0.0001), and 13% and 5% for HER2 (p = 0.0004). Conclusion Our findings strengthen the concept that changes in receptor expression may occur during the natural history of breast cancer, suggesting clinical implications and a possible impact on treatment choice.
KW - Breast cancer
KW - Concordance
KW - HER2
KW - Hormone receptors
UR - http://www.scopus.com/inward/record.url?scp=84891781085&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84891781085&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2013.10.004
DO - 10.1016/j.ejca.2013.10.004
M3 - Article
AN - SCOPUS:84891781085
VL - 50
SP - 277
EP - 289
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 2
ER -