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Metastasis biopsy receptor status discordance may alter treatment plan
Amir E. J Clin Oncol. 2011;doi:10.1200/JCO.2010.33.5232.
A change in the receptor status of a tumor between primary tumor biopsy and metastasis biopsy resulted in physician changes to the treatment plan for one in seven women, according to the results of a recently published study.
Frequently, the ER, PR or HER-2 status of a tumor can be different in a secondary or metastasis of the primary tumor than it was in the primary tumor biopsy.
To assess this, researchers performed an additional biopsy of the metastases and analyzed it for ER, PR and HER-2 status. A treating oncologist developed a treatment plan before seeing the results, then did so again after seeing updated tumor characteristics.
During a 2-year period, 121 women underwent a second biopsy. Of these women, 80% had receptor status analyzed. Overall, 37.6% of women had discordance in one or more receptors between their primary cancer and the metastasis biopsy.
The greatest rate of discordance was in PR status, followed by ER and HER-2 (see figure).
This change in receptor status led to a 14% change in treatment plan (95% CI, 8.4-21.5) but had no effect on time to treatment failure or OS.