Discordant hormone receptor and human epidermal growth factor receptor 2 status in bone metastases compared to primary breast cancer. (November 2013)

• Record Type: Journal Article
• Authors: Aurilio, Gaetano; Monfardini, Lorenzo; Rizzo, Stefania; Sciandivasci, Angela; Preda, Lorenzo; Bagnardi, Vincenzo; Disalvatore, Davide; Pruneri, Giancarlo; Munzone, Elisabetta; Della Vigna, Paolo; Renne, Giuseppe; Bellomi, Massimo; Curigliano, Giuseppe; Goldhirsch, Aron; Nolè, Franco
• Is Part Of: Acta oncologica. Volume 52:Number 8(2013)
• Page Start: 1649
• Page End: 1656
• Publication Date: 2013-11
• Subjects: Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.992
• DOI: 10.3109/0284186X.2012.754990
• Languages: English
• ISSNs: 0284-186X

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background.</italic> In patients with metastatic breast cancer, the evaluation of the biological characteristics of metastatic bone deposits may be a valuable adjunct in clinical practice. We assessed the discordance in expression levels for estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) between primary tumor and bone metastases and its clinical impact on patient management. <italic>Material and methods</italic>. We retrospectively reviewed 363 CT-guided bone biopsies performed from January 1997 to December 2009. The proportions of ER, PgR and HER2 positive tumors at primary diagnosis and bone metastases, determined by IHC and/or FISH, were compared using McNemar's test. The impact of the biopsy reassessment on treatment choice was evaluated with Fisher's exact test. <italic>Results.</italic> We selected 109 metastatic breast cancer patients with histologically confirmed bone metastases. Among 107 assessable patients the overall discordance rate was detected in 22 (20.5%) and in 47 (43.9%) patients for ER and PgR, respectively, and in six of 86 assessable patients (6.9%) for HER2 status. The indication to change endocrine therapy occurred in 62% and 30% of patients with ER discordance and ER concordance, respectively (p = 0.01). The indication to change targeted therapy occurred in 67% and 8% of patients with HER2 discordance and HER2 concordance, respectively (p = 0.002). <italic>Conclusions.</italic> We confirm that biopsy of metastases, including bone metastases, for reassessment of biology should be considered, since it is likely to impact on treatment choice.</p> </abstract>