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There is uncertainty about the prognostic and predictive value of HER2-low status and whether HER2-low BC is an individual biologic subtype. In this study, we aimed to investigate the prognostic effect of HER2 expression status on survival in mBC patients treated with first-line ET plus CDK 4\/6i.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included patients with HR\u2009+\u2009\/HER2-negative mBC cancer who were treated with first-line CDK 4\/6i in combination with ET from January 2016 to March 2023. Patients were divided into two groups (HER2-low and zero), and survival and safety analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 201 patients were included in this study; of these, 73 (36.3%) had HER2-low disease and 128 (63.7%) had HER2-zero. There were 135 patients (67.2%) treated with ribociclib and 66 (32.8%) with palbociclib. Most of the patients (75.1%) received aromatase inhibitors as combination-endocrine therapy. Baseline characteristics were similar between the two groups. The median follow-up was 19.1\u00a0months (range: 2.5\u201378.4). The most common side effect was neutropenia (22.4%). The frequency of grade 3\u20134 toxicity was similar between the HER2-zero and low patients (32% vs 31.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.939). Visceral metastases were present in 44.8% of patients. Between the HER2-low and zero groups, median PFS (25.2 vs 22.6\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.972) and OS (not reached vs 37.5\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.707) showed no statistically significant differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prognostic value of HER2-low status remains controversial. Our study showed no significant effect of HER2 low expression on survival in patients receiving CDK 4\/6i plus ET.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-024-07291-0","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T11:02:00Z","timestamp":1711364520000},"page":"633-640","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effects of low HER2 expression on survival in patients with metastatic breast cancer treated with CDK 4\/6 inhibitors: a multicenter retrospective study"],"prefix":"10.1007","volume":"205","author":[{"given":"Murad","family":"Guliyev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclin Alkan","family":"\u015een","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lkay","family":"G\u00fclt\u00fcrk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nargiz","family":"Majidova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goncag\u00fcl","family":"Akda\u011f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ahadzade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hande","family":"Turna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nebi Serkan","family":"Demirci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"7291_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21708","volume":"72","author":"RL Siegel","year":"2022","unstructured":"Siegel RL, Miller KD, Fuchs HE, Jemal A (2022) Cancer statistics, 2022. 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Approval was granted by the Ethics Committee of \u0130stanbul University Cerrahpa\u015fa (Date: July 12, 2023 and Number: E-83045809\u2013604.01.01\u2013731418).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}