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Badr NM, Zaakouk M, Zhang Q, Kearns D, Kong A, Shaaban AM. Concordance between ER, PR, Ki67, and HER2-low expression in breast cancer by MammaTyper RT-qPCR and immunohistochemistry: implications for the practising pathologist. Histopathology 2024. [PMID: 38651302 DOI: 10.1111/his.15193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/21/2024] [Accepted: 03/30/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND There are limited data on the role of multigene tests and their correlation with immunohistochemistry (IHC), especially on core biopsy. MammaTyper is a quantitative conformite Europeeanne (CE) marked, National Institute for Health and Care excellence (NICE) approved, in in vitro diagnostic quantitative real-time polymerase chain reaction (RT-qPCR) test for assessment of mRNA expression of four biomarkers (ESR1, PGR, ERBB2, MKI67). METHODS We evaluated the concordance of MammaTyper with oestrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 by IHC on 133 core needle biopsies of breast cancer. HER2 was positive if IHC 3+ or 2+ and fluorescence in situ hybridization (FISH)-amplified. Global and hotspot Ki67 expression was analysed using a cutoff of ≥20% assessed manually and by digital image analysis. Agreements were expressed as overall percent agreement (OPA), positive percent agreement (PPA), negative percent agreement (NPA), and Cohen's kappa. RESULTS RT-qPCR results of ESR1 were highly concordant with IHC with OPA of 94.7% using 1% cutoff and 91.7% when the low ER-positive category was included. The PPA and NPA between RT-qPCR and IHC for PR was 91.5% and 88.0%, respectively, when using the 1% cutoff. For ERBB2/HER2, the OPA was 95% and the PPA was 84.6%. 40 of 72 HER2 IHC score 0 tumours were classified as ERBB2 low. Best concordance between MKI67 by MammaTyper and Ki67 IHC was achieved using hotspot digital image analysis (OPA: 87.2%, PPA: 90.6%, NPA: 80%). CONCLUSION RT-qPCR-based assessment of the mRNA expression of ESR1, PGR, ERBB2, and MKI67 showed high concordance with IHC, suggesting that the MammaTyper test on core needle biopsies represents a reliable, efficient, and reproducible alternative for breast cancer classification and refining HER2 low categorisation.
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Affiliation(s)
- Nahla M Badr
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Mohamed Zaakouk
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Cancer Pathology Department, National Cancer Institute, Cairo University, Giza, Egypt
| | - Qi Zhang
- Shuwen Biotech Co. Ltd., Hangzhou, Zhejiang Province, China
| | | | - Anthony Kong
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- King's College London, London, UK
| | - Abeer M Shaaban
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
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2
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Antos A, Topolska-Woś A, Woś M, Mitura A, Sarzyńska P, Lipiński T, Kurylcio A, Ziółkowski P, Świtalska M, Tkaczuk-Włach J, Gamian A, Polkowski WP, Staniszewska M. The unique monoclonal antibodies and immunochemical assay for comprehensive determination of the cell-bound and soluble HER2 in different biological samples. Sci Rep 2024; 14:3978. [PMID: 38368450 PMCID: PMC10874376 DOI: 10.1038/s41598-024-54590-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/14/2024] [Indexed: 02/19/2024] Open
Abstract
The expression of the HER2 (human epidermal growth factor receptor 2) protein in cancer cells is a well-established cancer marker used for diagnostic and therapeutic purposes in modern treatment protocols, especially in breast cancer. The gold-standard immunohistochemical diagnostic methods with the specific anti-HER2 antibodies are utilized in the clinic to measure expression level of the membrane-bound receptor. However, a soluble extracellular domain (ECD) of HER2 is released to the extracellular matrix, thus the blood assays for HER2 measurements present an attractive way for HER2 level determination. There is a need for accurate and validated assays that can be used to correlate the concentration of the circulating HER2 protein with disease clinical manifestations. Here we describe two monoclonal antibodies binding HER2 with a unique sequence of the complementarity-determining regions that recognize HER2 ECD. Development and validation of the sandwich enzyme-linked immunosorbent assay (ELISA) for quantification of the soluble HER2 in a variety of biological samples is also presented. The assay provides HER2 quantitation within a concentrations range from 1.56 to 100 ng/ml with sensitivity at the level of 0.5 ng/ml that meets the expectations for measurements of HER2 in the blood and tumor tissue samples. The method presents satisfactory intra- and inter-assay precision and accuracy for immunochemical quantification of biomarkers in biological samples. The utility of the generated monoclonal anti-HER2 antibodies has been confirmed for use in the precise measurement of HER2 (both cell-bound and soluble) in several types of biological material, including serum, solid tumor tissue, and cell culture medium. Additionally, the developed immunochemical tools have a potential for HER2 detection, not only in a wide range of sample types but also independently of the sample storage/pre-processing, allowing for comprehensive HER2 analysis in tissue (IHC), cultured cells (immunofluorescence) and blood (ELISA).
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Affiliation(s)
- Aleksandra Antos
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | | | - Marcin Woś
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | - Agata Mitura
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | - Paulina Sarzyńska
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | - Tomasz Lipiński
- Lukasiewicz Research Network - PORT Polish Center for Technology Development, Stabłowicka 147, 54-066, Wrocław, Poland
| | - Andrzej Kurylcio
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13, 20-080, Lublin, Poland
| | - Piotr Ziółkowski
- Department of Pathomorphology, Wrocław Medical University, Marcinkowskiego 1, 50-368, Wrocław, Poland
| | - Marta Świtalska
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Joanna Tkaczuk-Włach
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, Staszica 4/6, 20-081, Lublin, Poland
| | - Andrzej Gamian
- Laboratory of Medical Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Wojciech P Polkowski
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13, 20-080, Lublin, Poland
| | - Magdalena Staniszewska
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland.
- Faculty of Medicine, The John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708, Lublin, Poland.
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3
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Das R, Paira P. GSH resistant, luminescent 2-(pyren-1-yl)-1 H-imidazo[4,5- f][1,10]phenanthroline-based Ru(II)/Ir(III)/Re(I) complexes for phototoxicity in triple-negative breast cancer cells. Dalton Trans 2023; 52:15365-15376. [PMID: 37493615 DOI: 10.1039/d3dt01667f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Selective chemotherapeutic strategies necessitate the emergence of a photosensitive scaffold to abate the nuisance of cancer. In the current context, photo-activated chemotherapy (PACT) has, therefore, appeared to be very effective to vanquish the vehemence of triple-negative breast cancer (TNBC). Metal complexes have been identified to act well against cancer cell microenvironment (high GSH content, low pH, and hypoxia), and thus they have been employed in the treatment of various types of cancer. As TNBC is very challenging to treat owing to its poor prognosis, lack of a specific target, high chance of relapse, and strong metastatic ability, herein we have aspired to design GSH-resistant phototoxic Ru(II)/Ir(III)/Re(I) based pyrene imidazophenathroline complexes to selectively avert the triple-negative breast cancer. The application of complexes, [RuL], [IrL], and [ReL] in the absence and in the presence of GSH against MDA-MB-231TNBC cells, has revealed that they are very active upon irradiation of visible light compared to dark due to the creation of copious singlet oxygen (1O2) as reactive oxygen species (ROS). Among three synthesized complexes, [IrL] has shown outstanding potency (IC50 = 3.70 in the absence of GSH and IC50 = 3.90 in the presence of GSH). Also, the complex, [IrL] is capable of interacting with DNA with the highest binding constant (Kb = 0.023 × 106 M-1) along with higher protein binding affinity (KBSA = 0.0321 × 106 M-1). Here, it has been unveiled that all the complexes have been entitled to involve DNA covalent interaction through the available sites of both adenine and guanine bases.
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Affiliation(s)
- Rishav Das
- Department of Chemistry, School of advanced sciences, Vellore Institute of Technology, Vellore-632014, Tamilnadu, India.
| | - Priyankar Paira
- Department of Chemistry, School of advanced sciences, Vellore Institute of Technology, Vellore-632014, Tamilnadu, India.
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4
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Jiang M, Liu J, Li Q, Xu B. The trichotomy of HER2 expression confers new insights into the understanding and managing for breast cancer stratified by HER2 status. Int J Cancer 2023; 153:1324-1336. [PMID: 37314204 DOI: 10.1002/ijc.34570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 06/15/2023]
Abstract
Human epidermal growth factor receptor 2 (HER2) is a tyrosine kinase receptor that plays a carcinogenic role in breast cancer (BC) through gene amplification, mutation, or overexpression. Traditional methods of HER2 detection were divided into positive (immunohistochemistry (IHC) 3+/fluorescence in situ hybridization (FISH) amplification) and negative (IHC 2+/FISH-, IHC 1+, IHC 0) according to the dichotomy method. Anti-HER2-targeted therapies, such as trastuzumab and pertuzumab, have significantly improved the prognosis of HER2-positive patients. However, up to 75% to 85% of patients remain HER2-negative. In recent years, with the rapid development of molecular biology, gene detection technology, targeted therapy, and immunotherapy, researchers have actively explored the clinicopathological characteristics, molecular biological characteristics, treatment methods, and HER2 detection methods of HER2-low/zero breast cancer. With the clinical efficacy of new anti-HER2 targeted drugs, accurate classification of breast cancer is very important for the treatment choice. Therefore, the following review summarizes the necessity of developing HER2 detection methods, and the clinicopathological and drug treatment characteristics of patients with HER2-low/zero, to light the dawn of the treatment of breast cancer patients with HER2-low/zero expression.
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Affiliation(s)
- Mingxia Jiang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaxuan Liu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiao Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Mohanlal RD, Bouwer N, Willem P. HER2 Equivocal (Score = 2+) Breast Carcinoma Cases Identified by Immunohistochemistry at a South African Hospital. What is the Impact of Fluorescent In Situ Hybridization Testing? Appl Immunohistochem Mol Morphol 2023; 31:555-560. [PMID: 37471623 DOI: 10.1097/pai.0000000000001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/07/2023] [Indexed: 07/22/2023]
Abstract
The American Society of Clinical Oncology and the College of American Pathologists (ASCO/CAP) guidelines are used for human epidermal growth factor receptor 2 (HER2) reporting in breast carcinoma. Cases that demonstrate weak to moderate complete membrane immunohistochemical staining in >10% of the tumor are scored as 2+ (equivocal). This study aimed to determine what proportion of HER2 immunohistochemistry (IHC) score = 2+ breast carcinomas were confirmed to be positive by HER2 fluorescent in situ hybridization (FISH). There were 241 HER2 IHC score = 2+ breast carcinomas included. Most (74.3%) carcinomas were estrogen and progesterone receptor-positive. Invasive breast carcinoma of no special type (89.2%) was the commonest histologic subtype. Most tumors were grade 2 (64.3%). As per the FISH report, at the time of diagnosis, 27 cases (11.2%) were HER2 FISH positive. All HER2 FISH equivocal cases and one FISH positive case assessed using the 2013 ASCO/CAP HER2 criteria were reclassified to HER2 FISH negative when the 2018 criteria were applied. There was a high level of agreement (κ = 0.979) between HER2 FISH results obtained using the 2013 and the 2018 criteria. This study provides insight into the frequency of HER2 FISH positivity (11.2%) among HER2 IHC score = 2+ breast carcinomas and the impact of modifications to the ASCO/CAP HER2 guidelines. Elimination of the HER2 FISH equivocal category by the 2018 guidelines has reduced the need for repeat testing and simplified clinical management. Reclassification of previous HER2 FISH positive to negative has resulted in some patients being ineligible for costly anti-HER therapy.
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Affiliation(s)
- Reena Dhansukh Mohanlal
- Chris Hani Baragwanath Academic Hospital Histopathology Laboratory, National Health Laboratory Services and Department of Anatomical Pathology, School of Pathology, University of the Witwatersrand
| | - Nikki Bouwer
- National Health Laboratory Services, Charlotte Maxeke Johannesburg Academic Hospital, Department of Molecular Medicine and Haematology, School of Pathology, University of the Witwatersrand
| | - Pascale Willem
- Department of Molecular Medicine and Hematology, School of Pathology, University of the Witwatersrand, Johannesburg and the National Health Laboratory Services, Johannesburg, South Africa
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Carretero-Barrio I, Caniego-Casas T, Rosas M, Sánchez MC, Martínez-Jáñez N, Chiva M, Sarrió D, Moreno-Bueno G, Palacios J, Pérez-Mies B. Evaluation of ERBB2 mRNA Expression in HER2-Equivocal (2+) Immunohistochemistry Cases. Cancers (Basel) 2023; 15:cancers15061688. [PMID: 36980575 PMCID: PMC10046044 DOI: 10.3390/cancers15061688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/23/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
Xpert Breast Cancer STRAT4 is a RT-qPCR platform that studies the mRNA expression of ESR1, PGR, MKI67 and ERBB2, providing a positive or negative result for each of these breast cancer biomarkers. Its concordance with immunohistochemistry (IHC) and in situ hybridization (ISH) has been previously demonstrated, but none of the previous works was focused on HER2-equivocal (2+) cases identified by IHC. Thus, we studied the concordance between IHC/ISH and STRAT4 results for 112 HER2 2+ IBC samples, using 148 HER2 0+, 1+ and 3+ (no-HER2 2+) samples for comparison. We found 91.3% accuracy for the determination of HER2 status globally, 99.3% for no-HER2 2+ samples and 80.7% for HER2 2+ samples. Regarding the other biomarkers, we obtained 96.4% accuracy for estrogen receptor, 84.1% for progesterone receptor and 58.2% for Ki67. Our results suggest that the use of ERBB2 mRNA for the evaluation of HER2 2+ cases is not a reliable reflex method to assess the ERBB2 amplification status.
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Affiliation(s)
- Irene Carretero-Barrio
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Faculty of Medicine, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
| | - Tamara Caniego-Casas
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
| | - Marta Rosas
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
| | - María Concepción Sánchez
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Servicio de Ginecología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Noelia Martínez-Jáñez
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Servicio de Oncología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Miguel Chiva
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Servicio de Radiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - David Sarrió
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Departamento de Bioquímica, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas ‘Alberto Sols’, Conexión Cáncer (UAM-CSIC), 28029 Madrid, Spain
| | - Gema Moreno-Bueno
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Departamento de Bioquímica, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas ‘Alberto Sols’, Conexión Cáncer (UAM-CSIC), 28029 Madrid, Spain
- Fundación MD Anderson Internacional, 28033 Madrid, Spain
| | - José Palacios
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Faculty of Medicine, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Correspondence: (J.P.); (B.P.-M.); Tel.: +34-91-336-8337 (J.P. & B.P.-M.)
| | - Belén Pérez-Mies
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Faculty of Medicine, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Correspondence: (J.P.); (B.P.-M.); Tel.: +34-91-336-8337 (J.P. & B.P.-M.)
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7
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Xu Y, Zhang Y, Li N, Yang M, Xiang T, Huo D, Qiu Z, Yang L, Hou C. An ultra-sensitive dual-signal ratiometric electrochemical aptasensor based on functionalized MOFs for detection of HER2. Bioelectrochemistry 2022; 148:108272. [DOI: 10.1016/j.bioelechem.2022.108272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/31/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022]
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8
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Müller V, Banys-Paluchowski M, Friedl TWP, Fasching PA, Schneeweiss A, Hartkopf A, Wallwiener D, Rack B, Meier-Stiegen F, Huober J, Rübner M, Hoffmann O, Müller L, Janni W, Wimberger P, Jäger B, Pantel K, Riethdorf S, Harbeck N, Fehm T. Prognostic relevance of the HER2 status of circulating tumor cells in metastatic breast cancer patients screened for participation in the DETECT study program. ESMO Open 2021; 6:100299. [PMID: 34839105 PMCID: PMC8637493 DOI: 10.1016/j.esmoop.2021.100299] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/25/2021] [Accepted: 10/11/2021] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Circulating tumor cells (CTCs) have been reported to predict clinical outcome in metastatic breast cancer (MBC). Biology of CTCs may differ from that of the primary tumor and HER2-positive CTCs are found in some patients with HER2-negative tumors. PATIENTS AND METHODS Patients with HER2-negative MBC were screened for participation in DETECT III and IV trials before the initiation of a new line of therapy. Blood samples were analyzed using CELLSEARCH. CTCs were labeled with an anti-HER2 antibody and classified according to staining intensity (negative, weak, moderate, or strong staining). RESULTS Screening blood samples were analyzed in 1933 patients with HER2-negative MBC. As many as 1217 out of the 1933 screened patients (63.0%) had ≥1 CTC per 7.5 ml blood; ≥5 CTCs were detected in 735 patients (38.0%; range 1-35 078 CTCs, median 8 CTCs). HER2 status of CTCs was assessed in 1159 CTC-positive patients; ≥1 CTC with strong HER2 staining was found in 174 (15.0%) patients. The proportion of CTCs with strong HER2 staining among all CTCs of an individual patient ranged between 0.06% and 100% (mean 15.8%). Patients with estrogen receptor (ER)- and progesterone receptor (PR)-positive tumors were more likely to harbor ≥1 CTC with strong HER2 staining. CTC status was significantly associated with overall survival (OS). Detection of ≥1 CTC with strong HER2 staining was associated with shorter OS [9.7 (7.1-12.3) versus 16.5 (14.9-18.1) months in patients with CTCs with negative-to-moderate HER2 staining only, P = 0.013]. In multivariate analysis, age, ER status, PR status, Eastern Cooperative Oncology Group performance status, therapy line, and CTC status independently predicted OS. CONCLUSION CTC detection in patients with HER2-negative disease is a strong prognostic factor. Presence of ≥1 CTC with strong HER2 staining was associated with shorter OS, supporting a biological role of HER2 expression on CTCs.
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Affiliation(s)
- V Müller
- Department of Gynecology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| | - M Banys-Paluchowski
- Gynecology and Obstetrics Department, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - T W P Friedl
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - P A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - A Schneeweiss
- Division Gynecologic Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany
| | - A Hartkopf
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - D Wallwiener
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - B Rack
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - F Meier-Stiegen
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - J Huober
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - M Rübner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - O Hoffmann
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - L Müller
- OnkologieUnterEms, Leer, Germany
| | - W Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - P Wimberger
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus Dresden, TU Dresden, Germany; National Center for Tumor Diseases (NCT), Dresden, Germany
| | - B Jäger
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - K Pantel
- Institute of Tumor Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - S Riethdorf
- Institute of Tumor Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - N Harbeck
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, LMU University Hospital, Munich, Germany
| | - T Fehm
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
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9
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Parisi F, Muscatello LV, Civita P, Lessi F, Menicagli M, Millanta F, Brunetti B, Benazzi C, Sarli G, Freer G, Pistello M, Mazzanti CM, Poli A. Pathological Features and Molecular Phenotype of MMTV Like-Positive Feline Mammary Carcinomas. Animals (Basel) 2021; 11:ani11102821. [PMID: 34679842 PMCID: PMC8532932 DOI: 10.3390/ani11102821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Mouse mammary tumour virus-like (MMTV-like) is suspected to be involved in human breast cancer and feline mammary carcinomas (FMCs). We previously reported the identification of MMTV-like sequences and viral protein in six of 78 FMCs collected in Tuscany, Italy. To corroborate this finding, FMCs samples collected from a different geographic area were investigated. MMTV-like sequences and p14 protein were identified in three of 24 FMCs collected at the University of Bologna, one tubular carcinoma, one tubulopapillary carcinoma and one ductal carcinoma. All the examined FMCs from Pisa and Bologna were submitted to immunohistochemistry for molecular phenotype characterization. Of the nine positive FMCs, six were basal-like and three luminal-like. This study highlights the presence of MMTV-like sequences and protein in FMCs of different geographic areas. The characterization of molecular phenotype could contribute to understand the possible role of MMTV-like virus in FMC biological behaviour. Abstract In the last few years MMTV-like nucleotide sequences were detected in some feline and canine mammary tumours. Due to the confirmed role of cats in the epidemiology of the MMTV-like virus, the aim of this study was to investigate the main pathological features of positive feline mammary carcinomas (FMCs). Twenty-four FMCs were collected at the University of Bologna, submitted to laser microdissection and analysed by nested fluorescence-PCR using primer sets specific for MMTV env sequence. For immunohistochemistry, an antibody against MMTV protein 14 (p14) was used. MMTV-like sequences were detected in three out of 24 FMCs (12.5%), one tubular carcinoma, one tubulopapillary carcinoma and one ductal carcinoma. All PCR-positive tumours were also positive for p14. Multiple nucleotide alignment has shown similarity to MMTV ranging from 98% to 100%. All the 102 examined FMCs were submitted to immunohistochemistry for molecular phenotyping. Of the nine MMTV-like positive FMCs, six were basal-like and three luminal-like. Our results demonstrate MMTV-like sequences and protein in FMCs of different geographic areas. Molecular phenotyping could contribute to understand the possible role of MMTV-like virus in FMC tumor biology.
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Affiliation(s)
- Francesca Parisi
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy; (F.P.); (F.M.)
| | - Luisa Vera Muscatello
- Department of Veterinary Sciences, University of Bologna, Via Tolara di sopra n. 43, 40064 Ozzano dell’Emilia, Italy; (L.V.M.); (B.B.); (C.B.); (G.S.)
| | - Prospero Civita
- School of Pharmacy and Pharmaceutical Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff CF14 4EP, UK;
| | - Francesca Lessi
- Fondazione Pisana per la Scienza Onlus, Via Ferruccio Giovannini n. 13, 56017 San Giuliano Terme, Italy; (F.L.); (M.M.); (C.M.M.)
| | - Michele Menicagli
- Fondazione Pisana per la Scienza Onlus, Via Ferruccio Giovannini n. 13, 56017 San Giuliano Terme, Italy; (F.L.); (M.M.); (C.M.M.)
| | - Francesca Millanta
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy; (F.P.); (F.M.)
| | - Barbara Brunetti
- Department of Veterinary Sciences, University of Bologna, Via Tolara di sopra n. 43, 40064 Ozzano dell’Emilia, Italy; (L.V.M.); (B.B.); (C.B.); (G.S.)
| | - Cinzia Benazzi
- Department of Veterinary Sciences, University of Bologna, Via Tolara di sopra n. 43, 40064 Ozzano dell’Emilia, Italy; (L.V.M.); (B.B.); (C.B.); (G.S.)
| | - Giuseppe Sarli
- Department of Veterinary Sciences, University of Bologna, Via Tolara di sopra n. 43, 40064 Ozzano dell’Emilia, Italy; (L.V.M.); (B.B.); (C.B.); (G.S.)
| | - Giulia Freer
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi n. 10, 56126 Pisa, Italy; (G.F.); (M.P.)
| | - Mauro Pistello
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi n. 10, 56126 Pisa, Italy; (G.F.); (M.P.)
| | - Chiara Maria Mazzanti
- Fondazione Pisana per la Scienza Onlus, Via Ferruccio Giovannini n. 13, 56017 San Giuliano Terme, Italy; (F.L.); (M.M.); (C.M.M.)
| | - Alessandro Poli
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy; (F.P.); (F.M.)
- Correspondence:
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