The TRAR gene classifier to predict response to neoadjuvant therapy in HER2‐positive and ER‐positive breast cancer patients: an explorative analysis from the NeoSphere trial. Issue 12 (17th December 2021)

• Record Type: Journal Article
• Authors: Triulzi, Tiziana; Bianchini, Giampaolo; Di Cosimo, Serena; Pienkowski, Tadeusz; Im, Young‐Hyuck; Bianchi, Giulia Valeria; Galbardi, Barbara; Dugo, Matteo; De Cecco, Loris; Tseng, Ling‐Ming; Liu, Mei‐Ching; Bermejo, Begoña; Semiglazov, Vladimir; Viale, Giulia; de la Haba‐Rodriguez, Juan; Oh, Do‐Youn; Poirier, Brigitte; Valagussa, Pinuccia; Gianni, Luca; Tagliabue, Elda
• Is Part Of: Molecular oncology. Volume 16:Issue 12(2022)
• Page Start: 2355
• Page End: 2366
• Publication Date: 2021-12-17
• Subjects: breast cancer -- gene expression profile -- HER2 -- pertuzumab -- predictive biomarker -- trastuzumab; Cancer -- Molecular aspects -- Periodicals; 616.994005
• DOI: 10.1002/1878-0261.13141
• Languages: English
• ISSNs: 1574-7891

Abstract

Abstract : As most erb‐b2 receptor tyrosine kinase 2 (HER2)‐positive breast cancer (BC) patients currently receive dual HER2‐targeting added to neoadjuvant chemotherapy, improved methods for identifying individual response, and assisting postsurgical salvage therapy, are needed. Herein, we evaluated the 41‐gene classifier trastuzumab advantage risk model (TRAR) as a predictive marker for patients enrolled in the NeoSphere trial. TRAR scores were computed from RNA of 350 pre‐ and 166 post‐treatment tumor specimens. Overall, TRAR score was significantly associated with pathological complete response (pCR) rate independently of other predictive clinico‐pathological variables. Separate analyses according to estrogen receptor (ER) status showed a significant association between TRAR score and pCR in ER‐positive specimens but not in ER‐negative counterparts. Among ER‐positive BC patients not achieving a pCR, those with TRAR‐low scores in surgical specimens showed a trend for lower distant event‐free survival. In conclusion, in HER2‐positive/ER‐positive BC, TRAR is an independent predictor of pCR and represents a promising tool to select patients responsive to anti‐HER2‐based neoadjuvant therapy and to assist treatment escalation and de‐escalation strategies in this setting. Abstract : TRAR‐low score is an independent predictor of pathological complete response (pCR) to anti‐HER2 agents in patients with HER2‐positive and ER‐positive breast cancer of the NeoSphere study. The higher risk of relapse observed in these patients likely depends on modification by treatment of tumor proliferation and ER activity. TRAR is a promising tool to assist escalation and de‐escalation of anti‐HER2‐based treatment strategies.