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Clinical and biological heterogeneities in triple-negative breast cancer reveals a non-negligible role of HER2-low

HER2-low could be found in some patients with triple-negative breast cancer (TNBC). However, its potential impacts on clinical features and tumor biological characteristics in TNBC remain unclear. We enrolled 251 consecutive TNBC patients retrospectively, including 157 HER2-low (HER2 ) and 94 HER2-n...

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Published in:Breast cancer research : BCR 2023-03, Vol.25 (1), p.34-34, Article 34
Main Authors: Hu, Xi E, Yang, Ping, Chen, Songhao, Wei, Gang, Yuan, Lijuan, Yang, Zhenyu, Gong, Li, He, Li, Yang, Lin, Peng, Shujia, Dong, Yanming, He, Xianli, Bao, Guoqiang
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container_title Breast cancer research : BCR
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Yang, Ping
Chen, Songhao
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Peng, Shujia
Dong, Yanming
He, Xianli
Bao, Guoqiang
description HER2-low could be found in some patients with triple-negative breast cancer (TNBC). However, its potential impacts on clinical features and tumor biological characteristics in TNBC remain unclear. We enrolled 251 consecutive TNBC patients retrospectively, including 157 HER2-low (HER2 ) and 94 HER2-negtive (HER2 ) patients to investigate the clinical and prognostic features. Then, we performed single-cell RNA sequencing (scRNA-seq) with another seven TNBC samples (HER2 vs. HER2 , 4 vs. 3) prospectively to further explore the differences of tumor biological properties between the two TNBC phenotypes. The underlying molecular distinctions were also explored and then verified in the additional TNBC samples. Compared with HER2 TNBC, HER2 TNBC patients exhibited malignant clinical features with larger tumor size (P = 0.04), more lymph nodes involvement (P = 0.02), higher histological grade of lesions (P 
doi_str_mv 10.1186/s13058-023-01639-y
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However, its potential impacts on clinical features and tumor biological characteristics in TNBC remain unclear. We enrolled 251 consecutive TNBC patients retrospectively, including 157 HER2-low (HER2 ) and 94 HER2-negtive (HER2 ) patients to investigate the clinical and prognostic features. Then, we performed single-cell RNA sequencing (scRNA-seq) with another seven TNBC samples (HER2 vs. HER2 , 4 vs. 3) prospectively to further explore the differences of tumor biological properties between the two TNBC phenotypes. The underlying molecular distinctions were also explored and then verified in the additional TNBC samples. Compared with HER2 TNBC, HER2 TNBC patients exhibited malignant clinical features with larger tumor size (P = 0.04), more lymph nodes involvement (P = 0.02), higher histological grade of lesions (P &lt; 0.001), higher Ki67 status (P &lt; 0.01), and a worse prognosis (P &lt; 0.001; HR [CI 95%] = 3.44 [2.10-5.62]). Cox proportional hazards analysis showed that neoadjuvant systemic therapy, lymph nodes involvement and Ki67 levels were prognostic factors in HER2 TNBC but not in HER2 TNBC patients. ScRNA-seq revealed that HER2 TNBC which showed more metabolically active and aggressive hallmarks, while HER2 TNBC exhibited signatures more involved in immune activities with higher expressions of immunoglobulin-related genes (IGHG1, IGHG4, IGKC, IGLC2); this was further confirmed by immunofluorescence in clinical TNBC samples. Furthermore, HER2 and HER2 TNBC exhibited distinct tumor evolutionary characteristics. Moreover, HER2 TNBC revealed a potentially more active immune microenvironment than HER2 TNBC, as evidenced by positively active regulation of macrophage polarization, abundant CD8 effector T cells, enriched diversity of T-cell receptors and higher levels of immunotherapy-targeted markers, which contributed to achieve immunotherapeutic response. This study suggests that HER2 TNBC patients harbor more malignant clinical behavior and aggressive tumor biological properties than the HER2 phenotype. The heterogeneity of HER2 may be a non-negligible factor in the clinical management of TNBC patients. Our data provide new insights into the development of a more refined classification and tailored therapeutic strategies for TNBC patients.</description><identifier>ISSN: 1465-542X</identifier><identifier>ISSN: 1465-5411</identifier><identifier>EISSN: 1465-542X</identifier><identifier>DOI: 10.1186/s13058-023-01639-y</identifier><identifier>PMID: 36998014</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Bar codes ; Breast cancer ; Breast Neoplasms ; Cancer therapies ; CD8 antigen ; Clinical outcomes ; Effector cells ; ErbB-2 protein ; Female ; Gene expression ; HER2-low ; Heterogeneity ; Humans ; Immunofluorescence ; Immunotherapy ; Ki-67 Antigen ; Lymph nodes ; Lymphocytes T ; Macrophages ; Medical prognosis ; Medical records ; Medical research ; Medicine, Experimental ; Microenvironments ; Phenotypes ; Prognosis ; Retrospective Studies ; RNA sequencing ; Single-cell RNA sequencing ; T cells ; Triple Negative Breast Neoplasms - drug therapy ; Triple Negative Breast Neoplasms - therapy ; Triple-negative breast cancer ; Tumor microenvironment ; Tumor Microenvironment - genetics ; Tumors</subject><ispartof>Breast cancer research : BCR, 2023-03, Vol.25 (1), p.34-34, Article 34</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><rights>2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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However, its potential impacts on clinical features and tumor biological characteristics in TNBC remain unclear. We enrolled 251 consecutive TNBC patients retrospectively, including 157 HER2-low (HER2 ) and 94 HER2-negtive (HER2 ) patients to investigate the clinical and prognostic features. Then, we performed single-cell RNA sequencing (scRNA-seq) with another seven TNBC samples (HER2 vs. HER2 , 4 vs. 3) prospectively to further explore the differences of tumor biological properties between the two TNBC phenotypes. The underlying molecular distinctions were also explored and then verified in the additional TNBC samples. Compared with HER2 TNBC, HER2 TNBC patients exhibited malignant clinical features with larger tumor size (P = 0.04), more lymph nodes involvement (P = 0.02), higher histological grade of lesions (P &lt; 0.001), higher Ki67 status (P &lt; 0.01), and a worse prognosis (P &lt; 0.001; HR [CI 95%] = 3.44 [2.10-5.62]). Cox proportional hazards analysis showed that neoadjuvant systemic therapy, lymph nodes involvement and Ki67 levels were prognostic factors in HER2 TNBC but not in HER2 TNBC patients. ScRNA-seq revealed that HER2 TNBC which showed more metabolically active and aggressive hallmarks, while HER2 TNBC exhibited signatures more involved in immune activities with higher expressions of immunoglobulin-related genes (IGHG1, IGHG4, IGKC, IGLC2); this was further confirmed by immunofluorescence in clinical TNBC samples. Furthermore, HER2 and HER2 TNBC exhibited distinct tumor evolutionary characteristics. Moreover, HER2 TNBC revealed a potentially more active immune microenvironment than HER2 TNBC, as evidenced by positively active regulation of macrophage polarization, abundant CD8 effector T cells, enriched diversity of T-cell receptors and higher levels of immunotherapy-targeted markers, which contributed to achieve immunotherapeutic response. 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However, its potential impacts on clinical features and tumor biological characteristics in TNBC remain unclear. We enrolled 251 consecutive TNBC patients retrospectively, including 157 HER2-low (HER2 ) and 94 HER2-negtive (HER2 ) patients to investigate the clinical and prognostic features. Then, we performed single-cell RNA sequencing (scRNA-seq) with another seven TNBC samples (HER2 vs. HER2 , 4 vs. 3) prospectively to further explore the differences of tumor biological properties between the two TNBC phenotypes. The underlying molecular distinctions were also explored and then verified in the additional TNBC samples. Compared with HER2 TNBC, HER2 TNBC patients exhibited malignant clinical features with larger tumor size (P = 0.04), more lymph nodes involvement (P = 0.02), higher histological grade of lesions (P &lt; 0.001), higher Ki67 status (P &lt; 0.01), and a worse prognosis (P &lt; 0.001; HR [CI 95%] = 3.44 [2.10-5.62]). Cox proportional hazards analysis showed that neoadjuvant systemic therapy, lymph nodes involvement and Ki67 levels were prognostic factors in HER2 TNBC but not in HER2 TNBC patients. ScRNA-seq revealed that HER2 TNBC which showed more metabolically active and aggressive hallmarks, while HER2 TNBC exhibited signatures more involved in immune activities with higher expressions of immunoglobulin-related genes (IGHG1, IGHG4, IGKC, IGLC2); this was further confirmed by immunofluorescence in clinical TNBC samples. Furthermore, HER2 and HER2 TNBC exhibited distinct tumor evolutionary characteristics. Moreover, HER2 TNBC revealed a potentially more active immune microenvironment than HER2 TNBC, as evidenced by positively active regulation of macrophage polarization, abundant CD8 effector T cells, enriched diversity of T-cell receptors and higher levels of immunotherapy-targeted markers, which contributed to achieve immunotherapeutic response. This study suggests that HER2 TNBC patients harbor more malignant clinical behavior and aggressive tumor biological properties than the HER2 phenotype. The heterogeneity of HER2 may be a non-negligible factor in the clinical management of TNBC patients. Our data provide new insights into the development of a more refined classification and tailored therapeutic strategies for TNBC patients.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>36998014</pmid><doi>10.1186/s13058-023-01639-y</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1465-542X
ispartof Breast cancer research : BCR, 2023-03, Vol.25 (1), p.34-34, Article 34
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subjects Bar codes
Breast cancer
Breast Neoplasms
Cancer therapies
CD8 antigen
Clinical outcomes
Effector cells
ErbB-2 protein
Female
Gene expression
HER2-low
Heterogeneity
Humans
Immunofluorescence
Immunotherapy
Ki-67 Antigen
Lymph nodes
Lymphocytes T
Macrophages
Medical prognosis
Medical records
Medical research
Medicine, Experimental
Microenvironments
Phenotypes
Prognosis
Retrospective Studies
RNA sequencing
Single-cell RNA sequencing
T cells
Triple Negative Breast Neoplasms - drug therapy
Triple Negative Breast Neoplasms - therapy
Triple-negative breast cancer
Tumor microenvironment
Tumor Microenvironment - genetics
Tumors
title Clinical and biological heterogeneities in triple-negative breast cancer reveals a non-negligible role of HER2-low
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