Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis
Purpose: Receptor conversion following neoadjuvant therapy in breast cancer may influence prognosis and adjuvant treatment decisions. This systematic review and meta-analysis evaluated the prognostic significance of changes in hormone receptor (HR) and HER2 status after neoadjuvant therapy. Methods:...
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| Language: | English |
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Elsevier
2025-08-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977625005338 |
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| author | Gavin P. Dowling Gordon R. Daly Cian M. Hehir Maen M. AlRawasdeh Gavin G. Calpin Sami Almasri Sinead Toomey Leonie S. Young Bryan T. Hennessey Arnold D.K. Hill |
| author_facet | Gavin P. Dowling Gordon R. Daly Cian M. Hehir Maen M. AlRawasdeh Gavin G. Calpin Sami Almasri Sinead Toomey Leonie S. Young Bryan T. Hennessey Arnold D.K. Hill |
| author_sort | Gavin P. Dowling |
| collection | DOAJ |
| description | Purpose: Receptor conversion following neoadjuvant therapy in breast cancer may influence prognosis and adjuvant treatment decisions. This systematic review and meta-analysis evaluated the prognostic significance of changes in hormone receptor (HR) and HER2 status after neoadjuvant therapy. Methods: This study was performed in accordance with PRISMA guidelines. A systematic search of the literature was conducted to identify studies assessing the prognostic effect of receptor conversion after neoadjuvant treatment in breast cancer. Studies reporting receptor status before and after neoadjuvant therapy, with associated survival outcomes, were included. Pooled hazard ratios (HRs) for disease-free survival (DFS) and overall survival (OS) were calculated using random-effects models. Results: Twenty-two studies (n = 5370) were included in this meta-analysis. HR gain demonstrated significantly improved DFS (HR 0.49, 95 % CI 0.25–0.97; p = 0.04), but no OS benefit. HR loss was associated with both significantly worse DFS (HR 3.42, 95 % CI 1.93–6.08; p < 0.001) and OS (HR 1.99, 95 % CI 1.04–3.84; p = 0.04). HER2 gain had a negative impact on DFS (HR 1.89, 95 % CI 1.00–3.58; p = 0.05), with no significant effect on OS. HER2 loss was associated with significantly poorer DFS (HR 1.92, 95 % CI 1.51–2.43; p < 0.001) and OS (HR 2.20, 95 % CI 1.44–3.38; p < 0.001). Conclusion: This systematic review and meta-analysis demonstrates that receptor conversion following neoadjuvant therapy in breast cancer significantly impacts survival outcomes. Specifically, gaining HR positivity is associated with improved DFS, while losing HR positivity correlates with worse DFS and OS. With regards to HER2, gaining positivity is associated with worse DFS, and losing positivity is associated with worse DFS and OS, compared to patients who maintain their initial status. These findings underscore the potential importance of reassessing receptor status after neoadjuvant therapy to tailor subsequent treatment decisions accurately. |
| format | Article |
| id | doaj-art-48ca8e90dae24de3b4b65c4eb9b2f295 |
| institution | DOAJ |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
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| series | Breast |
| spelling | doaj-art-48ca8e90dae24de3b4b65c4eb9b2f2952025-08-20T03:13:21ZengElsevierBreast1532-30802025-08-018210451610.1016/j.breast.2025.104516Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysisGavin P. Dowling0Gordon R. Daly1Cian M. Hehir2Maen M. AlRawasdeh3Gavin G. Calpin4Sami Almasri5Sinead Toomey6Leonie S. Young7Bryan T. Hennessey8Arnold D.K. Hill9Department of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Medical Oncology Lab, Department of Molecular Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Beaumont Hospital, Dublin, Ireland; Corresponding author. Royal College of Surgeons in Ireland (RCSI), 123 St Stephen's Green, Dublin, Ireland.Department of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Beaumont Hospital, Dublin, IrelandDepartment of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Beaumont Hospital, Dublin, IrelandDepartment of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, IrelandDepartment of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Beaumont Hospital, Dublin, IrelandDepartment of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, IrelandMedical Oncology Lab, Department of Molecular Medicine, RCSI University of Medicine and Health Sciences, Dublin, IrelandDepartment of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Beaumont Hospital, Dublin, IrelandMedical Oncology Lab, Department of Molecular Medicine, RCSI University of Medicine and Health Sciences, Dublin, IrelandDepartment of Surgery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Beaumont Hospital, Dublin, IrelandPurpose: Receptor conversion following neoadjuvant therapy in breast cancer may influence prognosis and adjuvant treatment decisions. This systematic review and meta-analysis evaluated the prognostic significance of changes in hormone receptor (HR) and HER2 status after neoadjuvant therapy. Methods: This study was performed in accordance with PRISMA guidelines. A systematic search of the literature was conducted to identify studies assessing the prognostic effect of receptor conversion after neoadjuvant treatment in breast cancer. Studies reporting receptor status before and after neoadjuvant therapy, with associated survival outcomes, were included. Pooled hazard ratios (HRs) for disease-free survival (DFS) and overall survival (OS) were calculated using random-effects models. Results: Twenty-two studies (n = 5370) were included in this meta-analysis. HR gain demonstrated significantly improved DFS (HR 0.49, 95 % CI 0.25–0.97; p = 0.04), but no OS benefit. HR loss was associated with both significantly worse DFS (HR 3.42, 95 % CI 1.93–6.08; p < 0.001) and OS (HR 1.99, 95 % CI 1.04–3.84; p = 0.04). HER2 gain had a negative impact on DFS (HR 1.89, 95 % CI 1.00–3.58; p = 0.05), with no significant effect on OS. HER2 loss was associated with significantly poorer DFS (HR 1.92, 95 % CI 1.51–2.43; p < 0.001) and OS (HR 2.20, 95 % CI 1.44–3.38; p < 0.001). Conclusion: This systematic review and meta-analysis demonstrates that receptor conversion following neoadjuvant therapy in breast cancer significantly impacts survival outcomes. Specifically, gaining HR positivity is associated with improved DFS, while losing HR positivity correlates with worse DFS and OS. With regards to HER2, gaining positivity is associated with worse DFS, and losing positivity is associated with worse DFS and OS, compared to patients who maintain their initial status. These findings underscore the potential importance of reassessing receptor status after neoadjuvant therapy to tailor subsequent treatment decisions accurately.http://www.sciencedirect.com/science/article/pii/S0960977625005338Breast cancerReceptor conversionHER2Hormone receptorNeoadjuvant therapyPrognosis |
| spellingShingle | Gavin P. Dowling Gordon R. Daly Cian M. Hehir Maen M. AlRawasdeh Gavin G. Calpin Sami Almasri Sinead Toomey Leonie S. Young Bryan T. Hennessey Arnold D.K. Hill Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis Breast Breast cancer Receptor conversion HER2 Hormone receptor Neoadjuvant therapy Prognosis |
| title | Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis |
| title_full | Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis |
| title_fullStr | Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis |
| title_full_unstemmed | Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis |
| title_short | Prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer: a systematic review & meta-analysis |
| title_sort | prognostic significance of receptor conversion following neoadjuvant therapy in breast cancer a systematic review amp meta analysis |
| topic | Breast cancer Receptor conversion HER2 Hormone receptor Neoadjuvant therapy Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S0960977625005338 |
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