Breast cancer ER, PR, and HER2 expression variance by germline cancer predisposition genes.

Authors

null

Grace Wei

USF Health Morsani College of Medicine, Tampa, FL

Grace Wei , Marilin Rosa , Maxine Chang , Brian J. Czerniecki , Xia Wang

Organizations

USF Health Morsani College of Medicine, Tampa, FL, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, GeneHome, H. Lee Moffitt Cancer Center, Tampa, FL, Hosp of the Univ of Pennsylvania, Philadelphia, PA, Moffitt Cancer Center, Tampa, FL

Research Funding

No funding received
None

Background: The association between breast cancer characteristics and survival with estrogen receptor (ER) and progesterone receptor (PR) expression has been primarily studied via binomial categories, ER-positive and ER-negative. In order to better characterize germline genetic influences on these markers, we investigated their IHC expression semi-quantitatively in cancer predisposition germline pathogenic variant (PV) carriers of the following genes: BRCA1,BRCA2,PALB2, TP53, PTEN, CDH1, ATM, CHEK2, and Lynch syndrome genes. The HER2 expression was also analyzed. Methods: We conducted a retrospective chart review of patients with germline panel genetic testing for cancer predisposition genes at Moffitt Cancer Center’s GeneHome clinic. Inclusion criteria included 1) women ≥18 years old, 2) breast cancer diagnosis, 3) cancer predisposition germline panel genetic test results, 4) available ER and PR expression levels, and 5) available HER expression and/or amplification status. ER, PR, and HER2 status were compared between PV carriers and non-PV carriers via Mann-Whitney U at p>0.05. Results: A total of 847 cases were reviewed for the study. Among 658 patients with a breast cancer diagnosis and complete ER PR data, 365 cases (55.5%) were non-PV carriers and 293 cases (44.5%) carried a PV in at least one of the genes listed above. Among 635 cases with available HER2 expression/amplification status, 355 (55.9%) cases were non-PV carriers and 288 (45.4%) cases were PV-carriers. When compared with non-PV carrier controls, BRCA1 PV carriers’ breast tumors had significantly lower ER and/or PR expression. Further, BRCA2 and TP53 PV tumors also displayed moderately lower ER expression. Contrarily, CHEK2 tumors displayed higher ER and PR expression compared to controls. Further, BRCA1 and BRCA2 PV carriers were more likely to have HER2- breast cancers. Conclusions: Differences in ER, PR, HER2 expression levels were observed in germline PV carrier breast cancers, signaling differential impacts by germline PVs on the tumor evolution process. It is likely that tumor differences in PV carriers influence responses to therapies, including hormone therapy, anti-HER2 therapy, and subsequent survival.

ER, PR and HER2 expressions based on germline pathogenic variants.


ER% mean (SD)
P-Value
PR% mean (SD)
P-Value
HER2- Case No. %
HER2+ Case No. %
P-Value
BRCA1
14.3 (32.7)
0
6.41 (20.2)
0
58 (98.3%)
1 (1.7%)
0
BRCA2
69.0 (38.0)
0.001
45.3 (37.7)
0.19
63 (95.5%)
3 (4.5%)
0
TP53
52.1 (46.7)
0.011
38.6 (44.7)
0.306
13 (61.9%)
8 (38.1%)
0.084
PALB2
68.2 (39.5)
0.114
39.5 (34.4)
0.163
20 (90.9%)
2 (9.1%)
0.112
ATM
80.1 (34.0)
0.609
51.0 (40.0)
0.631
21 (80.8%)
5 (19.2%)
0.471
CHEK2
93.3 (17.4)
0.003
72.0 (34.6)
0.001
32 (80.0%)
8 (20.0%)
0.462
MMRs
60.9 (47.8)
0.285
40.4 (42.5)
0.454
11 (61.1%)
7 (38.9%)
0.093
PTEN
96.8 (3.82)
0.305
83.8 (17.9)
0.066
4 (100%)
0 (0.0%)
0.368
Control/

Reference
78.0 (34.5)
-
48.8 (41.1)
-
276 (77.7%)
79 (22.3%)
-

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Prevention, Risk Reduction, and Hereditary Cancer

Track

Prevention, Risk Reduction, and Genetics

Sub Track

Cancer Genetics

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 10526)

DOI

10.1200/JCO.2021.39.15_suppl.10526

Abstract #

10526

Poster Bd #

Online Only

Abstract Disclosures