No significant benefit of pertuzumab was seen in other subtypes. Findings were similar in the HER2-single subgroup. Additionally, a significantly decreased hazard was observed for both OS (adjusted hazard ratio 0.45, 95% CI 0.25–0.80) and BCSS (aHR 0.46, 95% CI 0.24–0.86) with pertuzumab treatment. In patients with HER2-type tumors, the pCR rate was 71.9% in patients who received pertuzumab versus 43.5% in patients who did not (adjusted Odds Ratio 3.43, 95% CI 2.36–4.96).
ResultsīluePrint results were available for 719 patients. The associations between subtypes and pathological complete response (pCR), overall survival (OS) and breast cancer-specific survival (BCSS) were assessed, and pertuzumab benefit was evaluated within the BluePrint subgroups. Methodsįrom a cohort of patients with stage II-III HER2-positive breast cancer who were treated with neoadjuvant chemotherapy and trastuzumab with or without pertuzumab, 836 patients were selected for microarray gene expression analysis, followed by readout of BluePrint standard (HER2, Basal and Luminal) and dual subtypes (HER2-single, Basal-single, Luminal-single, HER2-Basal, Luminal-HER2, Luminal-HER2-Basal). Additionally, we evaluate its use as a biomarker for predicting response to trastuzumab-containing neoadjuvant chemotherapy with or without pertuzumab.
In this study, we determine the prognostic value of BluePrint subtyping in HER2-positive breast cancer. The introduction of pertuzumab has greatly improved pathological complete response (pCR) rates in HER2-positive breast cancer, yet effects on long-term survival have been limited and it is uncertain which patients derive most benefit.
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