Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer

K Van Baelen; T Geukens; M Maetens; V Tjan-Heijnen; C J Lord; S Linn; F-C Bidard; F Richard; W W Yang; R E Steele; S J Pettitt; C Van Ongeval; M De Schepper; E Isnaldi; I Nevelsteen; A Smeets; K Punie; L Voorwerk; H Wildiers; G Floris; A Vincent-Salomon; P W B Derksen; P Neven; E Senkus; E Sawyer; M Kok; C Desmedt

doi:10.1016/j.annonc.2022.05.006

Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer

K Van Baelen, T Geukens, M Maetens, V Tjan-Heijnen, C J Lord, S Linn, F-C Bidard, F Richard, W W Yang, R E Steele, S J Pettitt, C Van Ongeval, M De Schepper, E Isnaldi, I Nevelsteen, A Smeets, K Punie, L Voorwerk, H Wildiers, G FlorisA Vincent-Salomon, P W B Derksen, P Neven, E Senkus, E Sawyer, M Kok, C Desmedt^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

BACKGROUND: Invasive Lobular breast cancer (ILC) is the second most common type of breast cancer after invasive breast cancer of no special type (NST), representing up to 15% of all breast cancers.

DESIGN: Latest data on ILC are presented, focusing on diagnosis, molecular make-up according to the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) guidelines, treatment in the early and metastatic setting and ILC-focused clinical trials.

RESULTS: At the imaging level, MRI-based and novel PET/CT-based techniques can overcome the limitations of currently used imaging techniques for diagnosing ILC. At the pathology level, E-cadherin immunohistochemistry could help improving inter-pathologist agreement. The majority of patients with ILC do not seem to benefit as much from (neo-)adjuvant chemotherapy as patients with NST, although chemotherapy might be required in a subset of high-risk patients. No differences in treatment efficacy are seen for anti-HER2 therapies in the adjuvant setting and CDK4/6 inhibitors in the metastatic setting. The clinical utility of the commercially-available prognostic gene expression-based tests is unclear for patients with ILC. Several ESCAT alterations differ in frequency between ILC and NST. Germline BRCA1 and PALB2 alterations are less frequent in patients with ILC, while germline CDH1 (gene coding for E-cadherin) alterations are more frequent in patients with ILC. Somatic HER2 mutations are more frequent in ILC, especially in metastases (15% ILC versus 5% NST). A high tumour mutational burden, relevant for immune checkpoint inhibition, is more frequent in ILC metastases (16%) than NST metastases (5%). Tumours with somatic inactivating CDH1 mutations may be vulnerable for treatment with ROS1 inhibitors, a concept currently investigated in early and metastatic ILC.

CONCLUSIONS: ILC is a unique malignancy based on its pathological and biological features leading to differences in diagnosis as well as in treatment response, resistance and targets as compared to NST.

Original language	English
Pages (from-to)	769-785
Journal	Annals of Oncology
Volume	33
Issue number	8
Early online date	20 May 2022
DOIs	https://doi.org/10.1016/j.annonc.2022.05.006
Publication status	Published - Aug 2022

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1 Erratum / corrigendum / retractions

Corrigendum to "Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer": [Annals of Oncology 33 (2022) 769-785]
Van Baelen, K., Geukens, T., Maetens, M., Tjan-Heijnen, V., Lord, C. J., Linn, S., Bidard, F-C., Richard, F., Yang, W. W., Steele, R. E., Pettitt, S. J., Van Ongeval, C., De Schepper, M., Isnaldi, E., Nevelsteen, I., Smeets, A., Punie, K., Voorwerk, L., Wildiers, H., Floris, G., & 7 othersVincent Salomon, A., Derksen, P. W. B., Neven, P., Senkus, E., Sawyer, E., Kok, M. & Desmedt, C., Mar 2023, In: Annals of Oncology. 34, 3, p. 326
Research output: Contribution to journal › Erratum / corrigendum / retractions › Academic

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Van Baelen, K., Geukens, T., Maetens, M., Tjan-Heijnen, V., Lord, C. J., Linn, S., Bidard, F.-C., Richard, F., Yang, W. W., Steele, R. E., Pettitt, S. J., Van Ongeval, C., De Schepper, M., Isnaldi, E., Nevelsteen, I., Smeets, A., Punie, K., Voorwerk, L., Wildiers, H., ... Desmedt, C. (2022). Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer. Annals of Oncology, 33(8), 769-785. https://doi.org/10.1016/j.annonc.2022.05.006

@article{30387595b98b47918b9c71dba1f2d1c3,

title = "Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer",

abstract = "BACKGROUND: Invasive Lobular breast cancer (ILC) is the second most common type of breast cancer after invasive breast cancer of no special type (NST), representing up to 15% of all breast cancers.DESIGN: Latest data on ILC are presented, focusing on diagnosis, molecular make-up according to the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) guidelines, treatment in the early and metastatic setting and ILC-focused clinical trials.RESULTS: At the imaging level, MRI-based and novel PET/CT-based techniques can overcome the limitations of currently used imaging techniques for diagnosing ILC. At the pathology level, E-cadherin immunohistochemistry could help improving inter-pathologist agreement. The majority of patients with ILC do not seem to benefit as much from (neo-)adjuvant chemotherapy as patients with NST, although chemotherapy might be required in a subset of high-risk patients. No differences in treatment efficacy are seen for anti-HER2 therapies in the adjuvant setting and CDK4/6 inhibitors in the metastatic setting. The clinical utility of the commercially-available prognostic gene expression-based tests is unclear for patients with ILC. Several ESCAT alterations differ in frequency between ILC and NST. Germline BRCA1 and PALB2 alterations are less frequent in patients with ILC, while germline CDH1 (gene coding for E-cadherin) alterations are more frequent in patients with ILC. Somatic HER2 mutations are more frequent in ILC, especially in metastases (15% ILC versus 5% NST). A high tumour mutational burden, relevant for immune checkpoint inhibition, is more frequent in ILC metastases (16%) than NST metastases (5%). Tumours with somatic inactivating CDH1 mutations may be vulnerable for treatment with ROS1 inhibitors, a concept currently investigated in early and metastatic ILC.CONCLUSIONS: ILC is a unique malignancy based on its pathological and biological features leading to differences in diagnosis as well as in treatment response, resistance and targets as compared to NST.",

author = "{Van Baelen}, K and T Geukens and M Maetens and V Tjan-Heijnen and Lord, {C J} and S Linn and F-C Bidard and F Richard and Yang, {W W} and Steele, {R E} and Pettitt, {S J} and {Van Ongeval}, C and {De Schepper}, M and E Isnaldi and I Nevelsteen and A Smeets and K Punie and L Voorwerk and H Wildiers and G Floris and A Vincent-Salomon and Derksen, {P W B} and P Neven and E Senkus and E Sawyer and M Kok and C Desmedt",

note = "Copyright {\textcopyright} 2022. Published by Elsevier Ltd.",

year = "2022",

month = aug,

doi = "10.1016/j.annonc.2022.05.006",

language = "English",

volume = "33",

pages = "769--785",

journal = "Annals of Oncology",

issn = "0923-7534",

publisher = "Oxford University Press",

number = "8",

}

Van Baelen, K, Geukens, T, Maetens, M, Tjan-Heijnen, V, Lord, CJ, Linn, S, Bidard, F-C, Richard, F, Yang, WW, Steele, RE, Pettitt, SJ, Van Ongeval, C, De Schepper, M, Isnaldi, E, Nevelsteen, I, Smeets, A, Punie, K, Voorwerk, L, Wildiers, H, Floris, G, Vincent-Salomon, A, Derksen, PWB, Neven, P, Senkus, E, Sawyer, E, Kok, M & Desmedt, C 2022, 'Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer', Annals of Oncology, vol. 33, no. 8, pp. 769-785. https://doi.org/10.1016/j.annonc.2022.05.006

TY - JOUR

T1 - Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer

AU - Van Baelen, K

AU - Geukens, T

AU - Maetens, M

AU - Tjan-Heijnen, V

AU - Lord, C J

AU - Linn, S

AU - Bidard, F-C

AU - Richard, F

AU - Yang, W W

AU - Steele, R E

AU - Pettitt, S J

AU - Van Ongeval, C

AU - De Schepper, M

AU - Isnaldi, E

AU - Nevelsteen, I

AU - Smeets, A

AU - Punie, K

AU - Voorwerk, L

AU - Wildiers, H

AU - Floris, G

AU - Vincent-Salomon, A

AU - Derksen, P W B

AU - Neven, P

AU - Senkus, E

AU - Sawyer, E

AU - Kok, M

AU - Desmedt, C

PY - 2022/8

Y1 - 2022/8

N2 - BACKGROUND: Invasive Lobular breast cancer (ILC) is the second most common type of breast cancer after invasive breast cancer of no special type (NST), representing up to 15% of all breast cancers.DESIGN: Latest data on ILC are presented, focusing on diagnosis, molecular make-up according to the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) guidelines, treatment in the early and metastatic setting and ILC-focused clinical trials.RESULTS: At the imaging level, MRI-based and novel PET/CT-based techniques can overcome the limitations of currently used imaging techniques for diagnosing ILC. At the pathology level, E-cadherin immunohistochemistry could help improving inter-pathologist agreement. The majority of patients with ILC do not seem to benefit as much from (neo-)adjuvant chemotherapy as patients with NST, although chemotherapy might be required in a subset of high-risk patients. No differences in treatment efficacy are seen for anti-HER2 therapies in the adjuvant setting and CDK4/6 inhibitors in the metastatic setting. The clinical utility of the commercially-available prognostic gene expression-based tests is unclear for patients with ILC. Several ESCAT alterations differ in frequency between ILC and NST. Germline BRCA1 and PALB2 alterations are less frequent in patients with ILC, while germline CDH1 (gene coding for E-cadherin) alterations are more frequent in patients with ILC. Somatic HER2 mutations are more frequent in ILC, especially in metastases (15% ILC versus 5% NST). A high tumour mutational burden, relevant for immune checkpoint inhibition, is more frequent in ILC metastases (16%) than NST metastases (5%). Tumours with somatic inactivating CDH1 mutations may be vulnerable for treatment with ROS1 inhibitors, a concept currently investigated in early and metastatic ILC.CONCLUSIONS: ILC is a unique malignancy based on its pathological and biological features leading to differences in diagnosis as well as in treatment response, resistance and targets as compared to NST.

AB - BACKGROUND: Invasive Lobular breast cancer (ILC) is the second most common type of breast cancer after invasive breast cancer of no special type (NST), representing up to 15% of all breast cancers.DESIGN: Latest data on ILC are presented, focusing on diagnosis, molecular make-up according to the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) guidelines, treatment in the early and metastatic setting and ILC-focused clinical trials.RESULTS: At the imaging level, MRI-based and novel PET/CT-based techniques can overcome the limitations of currently used imaging techniques for diagnosing ILC. At the pathology level, E-cadherin immunohistochemistry could help improving inter-pathologist agreement. The majority of patients with ILC do not seem to benefit as much from (neo-)adjuvant chemotherapy as patients with NST, although chemotherapy might be required in a subset of high-risk patients. No differences in treatment efficacy are seen for anti-HER2 therapies in the adjuvant setting and CDK4/6 inhibitors in the metastatic setting. The clinical utility of the commercially-available prognostic gene expression-based tests is unclear for patients with ILC. Several ESCAT alterations differ in frequency between ILC and NST. Germline BRCA1 and PALB2 alterations are less frequent in patients with ILC, while germline CDH1 (gene coding for E-cadherin) alterations are more frequent in patients with ILC. Somatic HER2 mutations are more frequent in ILC, especially in metastases (15% ILC versus 5% NST). A high tumour mutational burden, relevant for immune checkpoint inhibition, is more frequent in ILC metastases (16%) than NST metastases (5%). Tumours with somatic inactivating CDH1 mutations may be vulnerable for treatment with ROS1 inhibitors, a concept currently investigated in early and metastatic ILC.CONCLUSIONS: ILC is a unique malignancy based on its pathological and biological features leading to differences in diagnosis as well as in treatment response, resistance and targets as compared to NST.

U2 - 10.1016/j.annonc.2022.05.006

DO - 10.1016/j.annonc.2022.05.006

M3 - (Systematic) Review article

C2 - 35605746

SN - 0923-7534

VL - 33

SP - 769

EP - 785

JO - Annals of Oncology

JF - Annals of Oncology

IS - 8

ER -

Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer

Abstract

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Research output

Corrigendum to "Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer": [Annals of Oncology 33 (2022) 769-785]

Cite this