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Characteristics, healthcare utilization, and outcomes of patients with HER2-low breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Treatment for HER2-low [defined as ImmunoHistoChemistry (IHC) 1 + or 2 + and negative/normal in Situ Hybridization (ISH)] breast cancer patients is rapidly evolving, yet we lack critical information about the HER2-low population.

Methods

We conducted a retrospective cohort study of women aged 18 years or older diagnosed with breast cancer between 2010 and 2016 in North Carolina. Analyses were conducted for the overall cohort and a stage IV sub-cohort. We examined demographic and clinical characteristics, and characterized prevalence of HER2-low disease and healthcare utilization. We estimated adjusted rate ratios for the association between HER2 classifications and utilization outcomes, and hazard ratios for 3-year all cause mortality (stage IV only).

Results

The overall and stage IV cohorts included 12,965 and 635 patients, respectively. HER2-low patients represented more than half of both cohorts (59% overall, 53% stage IV). HER2-low patients were more likely than IHC 0 patients to have hormone receptor (HR)-positive disease. In the stage IV cohort, HER2-low patients were more likely to be Black (26% vs. 16% IHC 0, p = 0.0159). In both cohorts, rates of hospitalizations were slightly higher among HER2-low patients. There were no survival differences between HER2-low and IHC 0 among stage IV patients.

Conclusion

New treatment options for HER2-low breast cancer may have potential for significant impact at the population level particularly for patients with stage IV disease. In light of racial differences between HER2-low and IHC 0 patients observed in our cohort, research- and practice-based efforts to ensure equitable adoption of new treatment guidelines for patients with HER2-low metastatic breast cancer will be essential.

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Data availability

The data that support the findings of this study are available from the Cancer Information & Population Health Resource (CIPHR) at the University of North Carolina Lineberger Cancer Center, but restrictions apply to the availability of these data, which were used under agreement for the current study, and so are not publicly available. Data are however available from the authors upon entering into usage agreements as managed by CIPHR.

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Acknowledgements

Work on this study was supported by the Cancer Information and Population Health Resource, UNC Lineberger Comprehensive Cancer Center, with funding provided by the University Cancer Research Fund via the state of North Carolina. We would also like to thank Amy Clark for project support and assistance with manuscript formatting and submission. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the North Carolina Department of Health and Human Services, Division of Public Health.

Funding

This study was funded by AstraZeneca and Daiichi Sankyo, Inc.

Author information

Authors and Affiliations

  1. Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Suite 210, Durham, NC, 27701, USA

    Devon K. Check & Lauren E. Wilson

  2. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Bradford E. Jackson, Katherine E. Reeder-Hayes, Lisa Spees & Stephanie B. Wheeler

  3. Yale Cancer Center, New Haven, CT, USA

    Michaela A. Dinan

  4. AstraZeneca, Gaithersburg, MD, USA

    Eleanor Faherty & Clara Lam

  5. Daiichi Sankyo, Basking Ridge, NH, USA

    Jackie Kwong & Sandhya Mehta

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  1. Devon K. Check
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  2. Bradford E. Jackson
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Contributions

MAD, DKC, LEW, SBW, CL: contributed to the conception and design of the study. BEJ: conducted data analyses. All authors contributed toward the interpretation of the findings. DKC: created the initial draft, while all authors contributed to critical review and revision of this manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Devon K. Check.

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Conflict of interest

DKC, BEJ, LS, LEW received research funding from AstraZeneca. CL, EF are employed by AstraZeneca. JK, SM are employed by Daiichi Sankyo, Inc.

Ethical approval

The University of North Carolina at Chapel Hill Biomedical Institutional Review Board and Duke University Health System Institutional Review Boards reviewed/approved the study.

Consent to participate

This study was conducted under a waiver of the informed consent requirement by the University of North Carolina at Chapel Hill Biomedical Institutional Review Board.

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Check, D.K., Jackson, B.E., Reeder-Hayes, K.E. et al. Characteristics, healthcare utilization, and outcomes of patients with HER2-low breast cancer. Breast Cancer Res Treat 203, 329–338 (2024). https://doi.org/10.1007/s10549-023-07142-4

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  • DOI: https://doi.org/10.1007/s10549-023-07142-4

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