Abstract
Background: HER2-positive breast cancer (BC) is a highly aggressive phenotype and accounts for 15–20% of all BC cases. The role of the host immune features in predictive response to anti-HER2 therapies and prognosis in BC is already suggested. We aimed to develop a predictive and prognostic model and examine its relevance to the clinical outcomes of patients with HER2-positive BC.Methods: Based on the single-sample gene set enrichment analysis (ssGSEA) scores of the signatures related to neoadjuvant trastuzumab therapy response, an immune effective score (IES) was constructed using principal component analysis algorithms. A bioinformatic analysis using 4 independent cohorts (GSE66305, n=88; GSE130786, n=110; TCGA, n=123; METABRIC, n=236) established associations between IES and clinical outcomes.Results: Genes associated with neoadjuvant trastuzumab therapy response enriched in pathways related to antitumor immune activities, including T cell receptor signaling pathway, Natural killer cell-mediated cytotoxicity and NF−kappa B signaling pathway. IES was demonstrated to be a predictive biomarker to neoadjuvant trastuzumab therapy benefits (GSE66305: area under the curve (AUC) = 0.804; GSE130786: AUC = 0.704). In addition, IES was identified as an independent prognostic factor for overall survival (OS) in the TCGA cohort (P = 0.036, hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.449–0.97) and METABRIC cohort (P = 0.037, HR: 0.9, 95% CI: 0.81–0.99).Conclusions: The IES has a predictive value for response to neoadjuvant trastuzumab therapy and independent prognostic value for HER2-positive breast cancer.
Author Correction to: Adjuvant Trastuzumab Therapy for Early HER2-Positive Breast Cancer in Iran: A Cost-Effectiveness and Scenario Analysis for an Optimal Treatment Strategy
