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Zhou YT, Chu JH, Zhao SH, Li GL, Fu ZY, Zhang SJ, Gao XH, Ma W, Shen K, Gao Y, Li W, Yin YM, Zhao C. Quantitative systems pharmacology modeling of HER2-positive metastatic breast cancer for translational efficacy evaluation and combination assessment across therapeutic modalities. Acta Pharmacol Sin 2024; 45:1287-1304. [PMID: 38360930 PMCID: PMC11130324 DOI: 10.1038/s41401-024-01232-9] [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: 08/09/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
HER2-positive (HER2+) metastatic breast cancer (mBC) is highly aggressive and a major threat to human health. Despite the significant improvement in patients' prognosis given the drug development efforts during the past several decades, many clinical questions still remain to be addressed such as efficacy when combining different therapeutic modalities, best treatment sequences, interindividual variability as well as resistance and potential coping strategies. To better answer these questions, we developed a mechanistic quantitative systems pharmacology model of the pathophysiology of HER2+ mBC that was extensively calibrated and validated against multiscale data to quantitatively predict and characterize the signal transduction and preclinical tumor growth kinetics under different therapeutic interventions. Focusing on the second-line treatment for HER2+ mBC, e.g., antibody-drug conjugates (ADC), small molecule inhibitors/TKI and chemotherapy, the model accurately predicted the efficacy of various drug combinations and dosing regimens at the in vitro and in vivo levels. Sensitivity analyses and subsequent heterogeneous phenotype simulations revealed important insights into the design of new drug combinations to effectively overcome various resistance scenarios in HER2+ mBC treatments. In addition, the model predicted a better efficacy of the new TKI plus ADC combination which can potentially reduce drug dosage and toxicity, while it also shed light on the optimal treatment ordering of ADC versus TKI plus capecitabine regimens, and these findings were validated by new in vivo experiments. Our model is the first that mechanistically integrates multiple key drug modalities in HER2+ mBC research and it can serve as a high-throughput computational platform to guide future model-informed drug development and clinical translation.
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Affiliation(s)
- Ya-Ting Zhou
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jia-Hui Chu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shu-Han Zhao
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Ge-Li Li
- Gusu School, Nanjing Medical University, Suzhou, 215000, China
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Zi-Yi Fu
- Department of Breast Disease Research Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Su-Jie Zhang
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Xue-Hu Gao
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
- Jiangsu Hengrui Medicine Co. Ltd, Shanghai, 200245, China
| | - Wen Ma
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Kai Shen
- Jiangsu Hengrui Medicine Co. Ltd, Shanghai, 200245, China
| | - Yuan Gao
- QSPMed Technologies, Nanjing, 210000, China
| | - Wei Li
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yong-Mei Yin
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Chen Zhao
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China.
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Zhou J, Tan H, Li W, Liu Z, Wu Y, Bai Y, Fu F, Jia X, Feng A, Liu H, Wang M. Radiomics Signatures Based on Multiparametric MRI for the Preoperative Prediction of the HER2 Status of Patients with Breast Cancer. Acad Radiol 2021; 28:1352-1360. [PMID: 32709582 DOI: 10.1016/j.acra.2020.05.040] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of our study was to preoperatively predict the human epidermal growth factor receptor 2 (HER2) status of patients with breast cancer using radiomics signatures based on single-parametric and multiparametric magnetic resonance imaging (MRI). METHODS Three hundred six patients with invasive ductal carcinoma of no special type (IDC-NST) were retrospectively enrolled. Quantitative imaging features were extracted from fat-suppressed T2-weighted and dynamic contrast-enhanced T1 weighted (DCE-T1) preoperative MRI. Then, three radiomics signatures based on fat-suppressed T2-weighted images, DCE-T1 images and their combination were developed using a support vector machine (SVM) to predict the HER2-positive vs HER2-negative status of patients with breast cancer. The area under the curve (AUC), accuracy, sensitivity, and specificity were calculated to assess the predictive performances of the signatures. RESULTS Twenty-eight quantitative radiomics features, namely, 14 texture features, 4 first-order features, 9 wavelet features, and 1 shape feature, were used to construct radiomics signatures. The performance of the radiomics signatures for distinguishing HER2-positive from HER2-negative breast cancer based on fat-suppressed T2-weighted images, DCE-T1 images, and their combination had an AUC of 0.74 (95% confidence interval [CI], 0.700 to 0.770), 0.71 (0.673 to 0.738), and 0.86 (0.832 to 0.882) in the primary cohort and 0.70 (0.666 to 0.744), 0.68 (0.650 to 0.726), and 0.81 (0.776 to 0.837) in the validation cohort, respectively. CONCLUSION Radiomics signatures based on multiparametric MRI represent a potential and efficient alternative tool to evaluate the HER2 status in patients with breast cancer.
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Affiliation(s)
- Jing Zhou
- Department of Medical Imaging Henan Provincial People's Hospital & Imaging Diagnosis of Neurological Diseases and Research Laboratory of Henan Province & People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Hongna Tan
- Department of Medical Imaging Henan Provincial People's Hospital & Imaging Diagnosis of Neurological Diseases and Research Laboratory of Henan Province & People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Wei Li
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zehua Liu
- School of Information Engineering, Zhengzhou University, Zhengzhou, Henan, China
| | - Yaping Wu
- Department of Medical Imaging Henan Provincial People's Hospital & Imaging Diagnosis of Neurological Diseases and Research Laboratory of Henan Province & People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Yan Bai
- Department of Medical Imaging Henan Provincial People's Hospital & Imaging Diagnosis of Neurological Diseases and Research Laboratory of Henan Province & People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Fangfang Fu
- Department of Medical Imaging Henan Provincial People's Hospital & Imaging Diagnosis of Neurological Diseases and Research Laboratory of Henan Province & People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Xin Jia
- Department of Radiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Aozi Feng
- First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | | | - Meiyun Wang
- Department of Medical Imaging Henan Provincial People's Hospital & Imaging Diagnosis of Neurological Diseases and Research Laboratory of Henan Province & People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
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Huang Z, Chen L, Wang Y, Fu L, Lv R. Molecular markers, pathology, and ultrasound features of invasive breast cancer. Clin Imaging 2021; 79:85-93. [PMID: 33895560 DOI: 10.1016/j.clinimag.2021.03.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Ultrasound is commonly used in breast cancer screening and diagnosis. The use of ultrasound features to predict the subtypes of invasive breast cancer is of great clinical significance, since it facilitates a fast and early diagnosis and treatment. The correlation between breast lesion ultrasound features and the breast cancer subtypes requires further investigation. METHODS 388 patients with invasive breast cancer were retrospectively analyzed by two sonographers. The tumor size, shape, margin, echogenicity, echotexture, posterior echo attenuation microcalcification, and blood vessel density were recorded. The correlation between the tumor ER, PR, HER2, and Ki67 status, the molecular subtypes, and the ultrasound features was analyzed using the chi-square test, Fisher's exact test, and multiple logistic regression. RESULTS ER and PR positivity were correlated with a low histologic grade, lymph node metastasis, and smaller-sized tumors. A hyperechoic or a mixed echogenicity was rare in the tumors of all groups but was enriched in the ER and PR tumors (9.57% and 7.64%, respectively, p < 0.01). A high percentage of posterior echo attenuation was found in the Ki67 low (53.94%) and ER+ (51.28%) tumors. Furthermore, heterogeneous and microcalcifications were enriched in HER2-positive tumors. In terms of the molecular subtypes, the luminal A subtype group had the lowest lymph node positivity and the smallest primary tumor size. The luminal B subtype had the lowest percentage of hyperechoic or mixed tumors. The HER2 subtype was positively correlated with microcalcification. Finally, TNBC showed the highest percentage of hyperechoic or mixed tumors and the lowest percentage of posterior echo attenuation and microcalcification. CONCLUSION Tumor pathologic and ultrasound features were correlated with invasive breast tumor molecular marker positivity and its molecular subtypes.
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Affiliation(s)
- Zhifang Huang
- Department of Ultrasound Medicine, Huashan Hospital Affiliated to Fudan University, China
| | - Li Chen
- Department of Ultrasound Medicine, Huashan Hospital Affiliated to Fudan University, China
| | - Yong Wang
- Department of Ultrasound Medicine, Huashan Hospital Affiliated to Fudan University, China.
| | - Lina Fu
- Department of Ultrasound Medicine, Huashan Hospital Affiliated to Fudan University, China
| | - Renhua Lv
- Department of Ultrasound Medicine, Huashan Hospital Affiliated to Fudan University, China
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Comparison of Antibodies for Immunohistochemistry-based Detection of HER3 in Breast Cancer. Appl Immunohistochem Mol Morphol 2019; 26:212-219. [PMID: 27389555 DOI: 10.1097/pai.0000000000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Growth factor receptor HER3 (ErbB3) lacks standardized immunohistochemistry (IHC)-based methods for formalin-fixed paraffin-embedded (FFPE) tissue samples. We compared 4 different anti-HER3 antibodies to explain the differences found in the staining results reported in the literature. MATERIALS AND METHODS Four commercial HER3 antibodies were tested on FFPE samples including mouse monoclonal antibody clones, DAK-H3-IC and RTJ1, rabbit monoclonal antibody clone SP71, and rabbit polyclonal antibody (SAB4500793). Membranous and cytoplasmic staining patterns were analyzed and scored as 0, 1+, or 2+ according to the intensity of the staining and completeness of membranous and cytoplasmic staining. A large collection of HER2-amplified breast cancers (n=177) was stained with the best performing HER3 antibody. The breast cancer cell line, MDA-453, and human prostate tissue were used as positive controls. IHC results were confirmed by analysis of flow cytometry performed on breast cancer cell lines. Staining results of FFPE samples were compared with samples fixed with an epitope-sensitive fixative (PAXgene). RESULTS Clear circumferential cell membrane staining was found only with the HER3 antibody clone DAK-H3-IC. Other antibodies (RTJ1, SP71, and polyclonal) yielded uncertain and nonreproducible staining results. In addition to cell membrane staining, DAK-H3-IC was also localized to the cytoplasm, but no nuclear staining was observed. In HER2-amplified breast cancers, 80% of samples were classified as 1+ or 2+ according to the HER3 staining on the cell membrane. The results from FFPE cell line samples were comparable to those obtained from unfixed cells in flow cytometry. IHC conducted on FFPE samples and on PAXgene-fixed samples showed equivalent results. CONCLUSIONS We conclude that IHC with the monoclonal antibody, DAK-H3-IC, on FFPE samples is a reliable staining method for use in translational research. Assessment of membranous HER3 expression may be clinically relevant in selecting patients who may most benefit from pertuzumab or other novel anti-HER3 therapies.
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Delmonico L, Costa MASM, Fournier MV, Romano SDO, Nascimento CMD, Barbosa AS, Moreira ADS, Scherrer LR, Ornellas MHF, Alves G. Mutation profiling in the PIK3CA, TP53, and CDKN2A genes in circulating free DNA and impalpable breast lesions. Ann Diagn Pathol 2019; 39:30-35. [PMID: 30634138 DOI: 10.1016/j.anndiagpath.2018.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 12/21/2018] [Accepted: 12/30/2018] [Indexed: 01/05/2023]
Abstract
Breast impalpable lesions have become a clinical dilemma because they are small, presenting a heterogeneous cellular phenotype. The aim of this study was to evaluate the mutational profile of the PIK3CA, TP53, and CDKN2A genes, comparing the mammary tissue with the respective circulating free DNA (cfDNA). The PIK3CA, TP53, and CDKN2A genes were sequenced (PCR-Sanger) in 58 women with impalpable lesions (49 malignant and 9 benign) with the respective cfDNA. The chi-square or Fisher's exact test was used to evaluate statistical significance between the clinical variables and mutational profile. A total of 51 out of 58 samples generated successful mutation profiles in both breast lesion and cfDNA. Of the 37 mutations detected, 10 (27%) and 16 (43%) mutations were detected in benign and malignant breast lesions, respectively, while 2 (5%) and 9 (24%) were found in cfDNA of women with benign and malignant lesions, respectively. The lymph node involvement with mutations in the PIK3CA in malignant lesions (P = 0.001), and the relationship between mutations in PIK3CA, comparing ductal tumors with benign lesions (P = 0.05), were statistically significant. This study detected different mutations in PIK3CA, TP53, and CDKN2A genes, which represent, in part, the heterogeneity of impalpable lesions. The results confirm that more studies should be conducted on the functional role of cfDNA in the impalpable lesions.
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Affiliation(s)
- Lucas Delmonico
- Circulating Biomarkers Laboratory, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil; Graduate Program in Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil.
| | | | | | | | | | | | - Aline Dos Santos Moreira
- Laboratory of Functional Genomics and Bioinformatics, PTDIS/FIOCRUZ, Rio de Janeiro 21040-900, Brazil
| | | | - Maria Helena Faria Ornellas
- Circulating Biomarkers Laboratory, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil; Graduate Program in Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil
| | - Gilda Alves
- Circulating Biomarkers Laboratory, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil; Graduate Program in Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil.
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Zhang L, Li J, Xiao Y, Cui H, Du G, Wang Y, Li Z, Wu T, Li X, Tian J. Identifying ultrasound and clinical features of breast cancer molecular subtypes by ensemble decision. Sci Rep 2015; 5:11085. [PMID: 26046791 PMCID: PMC4457139 DOI: 10.1038/srep11085] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/14/2015] [Indexed: 11/30/2022] Open
Abstract
Breast cancer is molecularly heterogeneous and categorized into four molecular subtypes: Luminal-A, Luminal-B, HER2-amplified and Triple-negative. In this study, we aimed to apply an ensemble decision approach to identify the ultrasound and clinical features related to the molecular subtypes. We collected ultrasound and clinical features from 1,000 breast cancer patients and performed immunohistochemistry on these samples. We used the ensemble decision approach to select unique features and to construct decision models. The decision model for Luminal-A subtype was constructed based on the presence of an echogenic halo and post-acoustic shadowing or indifference. The decision model for Luminal-B subtype was constructed based on the absence of an echogenic halo and vascularity. The decision model for HER2-amplified subtype was constructed based on the presence of post-acoustic enhancement, calcification, vascularity and advanced age. The model for Triple-negative subtype followed two rules. One was based on irregular shape, lobulate margin contour, the absence of calcification and hypovascularity, whereas the other was based on oval shape, hypovascularity and micro-lobulate margin contour. The accuracies of the models were 83.8%, 77.4%, 87.9% and 92.7%, respectively. We identified specific features of each molecular subtype and expanded the scope of ultrasound for making diagnoses using these decision models.
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Affiliation(s)
- Lei Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jing Li
- Department of Ultrasonic medicine, The 1st Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Yun Xiao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hao Cui
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Guoqing Du
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Wang
- Department of general surgery, The Second Hospital of Hebei Medical Universtiy, Shijiazhuang, Hebei, China
| | - Ziyao Li
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Tong Wu
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xia Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiawei Tian
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Elias SG, Adams A, Wisner DJ, Esserman LJ, van't Veer LJ, Mali WPTM, Gilhuijs KGA, Hylton NM. Imaging features of HER2 overexpression in breast cancer: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2014; 23:1464-83. [PMID: 24807204 DOI: 10.1158/1055-9965.epi-13-1170] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breast cancer imaging phenotype is diverse and may relate to molecular alterations driving cancer behavior. We systematically reviewed and meta-analyzed relations between breast cancer imaging features and human epidermal growth factor receptor type 2 (HER2) overexpression as a marker of breast cancer aggressiveness. MEDLINE and EMBASE were searched for mammography, breast ultrasound, magnetic resonance imaging (MRI), and/or [(18)F]fluorodeoxyglucose positron emission tomography studies through February 2013. Of 68 imaging features that could be pooled (85 articles, 23,255 cancers; random-effects meta-analysis), 11 significantly related to HER2 overexpression. Results based on five or more studies and robustness in subgroup analyses were as follows: the presence of microcalcifications on mammography [pooled odds ratio (pOR), 3.14; 95% confidence interval (CI), 2.46-4.00] or ultrasound (mass-associated pOR, 2.95; 95% CI, 2.34-3.71), branching or fine linear microcalcifications (pOR, 2.11; 95% CI, 1.07-4.14) or extremely dense breasts on mammography (pOR, 1.37; 95% CI, 1.07-1.76), and washout (pOR, 1.57; 95% CI, 1.11-2.21) or fast initial kinetics (pOR, 2.60; 95% CI, 1.43-4.73) on MRI all increased the chance of HER2 overexpression. Maximum [(18)F]fluorodeoxyglucose standardized uptake value (SUVmax) was higher upon HER2 overexpression (pooled mean difference, +0.76; 95% CI, 0.10-1.42). These results show that several imaging features relate to HER2 overexpression, lending credibility to the hypothesis that imaging phenotype reflects cancer behavior. This implies prognostic relevance, which is especially relevant as imaging is readily available during diagnostic work-up.
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Affiliation(s)
| | - Arthur Adams
- Department of Radiology, University Medical Center Utrecht, Utrecht
| | | | | | - Laura J van't Veer
- Laboratory Medicine, University of California, San Francisco, San Francisco, California
| | | | - Kenneth G A Gilhuijs
- Department of Radiology, University Medical Center Utrecht, Utrecht; Department of Radiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands; Departments of
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Bae MS, Moon WK, Chang JM, Cho N, Park SY, Won JK, Jeon YK, Moon HG, Han W, Park IA. Mammographic features of calcifications in DCIS: correlation with oestrogen receptor and human epidermal growth factor receptor 2 status. Eur Radiol 2013; 23:2072-8. [PMID: 23512196 DOI: 10.1007/s00330-013-2827-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/29/2013] [Accepted: 02/06/2013] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study investigated the correlation of oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status with the probability of malignancy (POM) of mammographic calcifications in ductal carcinoma in situ (DCIS). METHODS A total of 101 women (age range, 27-83 years) with pure DCIS that presented as mammographic calcifications were included. Three radiologists independently reviewed mammograms according to the BI-RADS lexicon and provided 100-point POM scores and a BI-RADS category. ER, HER2 and breast cancer subtypes were determined using immunohistochemistry (IHC) and fluorescence in situ hybridisation. Pairwise correlations between POM and IHC biomarker scores were calculated, and mammographic features were compared between breast cancer subtypes. RESULTS HER2 level positively correlated with the POM score (P < 0.0001) and BI-RADS category (P < 0.0001), and ER level inversely correlated with the POM score (P < 0.013) and BI-RADS category (P < 0.010). Fine linear branching (P = 0.004) and segmental (P = 0.014) calcifications were significantly associated with HER2-positive cancers, and clustered calcifications were more frequently observed in ER-positive cancers (P = 0.014). CONCLUSION HER2 status in DCIS correlated positively with the POM of mammographic calcifications, as determined by radiologists on the basis of the BI-RADS lexicon. KEY POINTS • Prediction of malignancy on mammographic ductal carcinoma in situ is difficult. • HER2 level correlated positively with the probability of malignancy assigned by radiologists. • ER level correlated inversely with the probability of malignancy assigned by radiologists. • HER2-positive DCIS more frequently exhibited fine linear branching or segmental calcifications. • ER-positive DCIS more frequently exhibited clustered calcifications.
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Affiliation(s)
- Min Sun Bae
- Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea
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Skandalis SS, Labropoulou VT, Ravazoula P, Likaki-Karatza E, Dobra K, Kalofonos HP, Karamanos NK, Theocharis AD. Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas. BMC Cancer 2011; 11:314. [PMID: 21791066 PMCID: PMC3199864 DOI: 10.1186/1471-2407-11-314] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 07/26/2011] [Indexed: 12/15/2022] Open
Abstract
Background Mammographic density (MD) and malignant-appearing microcalcifications (MAMCs) represent the earliest mammographic findings of non-palpable breast carcinomas. Matrix proteoglycans versican and decorin are frequently over-expressed in various malignancies and are differently involved in the progression of cancer. In the present study, we have evaluated the expression of versican and decorin in non-palpable breast carcinomas and their association with high risk mammographic findings and tumor characteristics. Methods Three hundred and ten patients with non-palpable suspicious breast lesions, detected during screening mammography, were studied. Histological examination was carried out and the expression of decorin, versican, estrogen receptor α (ERα), progesterone receptor (PR) and c-erbB2 (HER-2/neu) was assessed by immunohistochemistry. Results Histological examination showed 83 out of 310 (26.8%) carcinomas of various subtypes. Immunohistochemistry was carried out in 62/83 carcinomas. Decorin was accumulated in breast tissues with MD and MAMCs independently of the presence of malignancy. In contrast, versican was significantly increased only in carcinomas with MAMCs (median ± SE: 42.0 ± 9.1) and MD (22.5 ± 10.1) as compared to normal breast tissue with MAMCs (14.0 ± 5.8), MD (11.0 ± 4.4) and normal breast tissue without mammographic findings (10.0 ± 2.0). Elevated levels of versican were correlated with higher tumor grade and invasiveness in carcinomas with MD and MAMCs, whereas increased amounts of decorin were associated with in situ carcinomas in MAMCs. Stromal deposition of both proteoglycans was related to higher expression of ERα and PR in tumor cells only in MAMCs. Conclusions The specific accumulation of versican in breast tissue with high MD and MAMCs only in the presence of malignant transformation and its association with the aggressiveness of the tumor suggests its possible use as molecular marker in non-palpable breast carcinomas.
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Affiliation(s)
- Spyros S Skandalis
- Laboratory of Biochemistry, Department of Chemistry, University of Patras, Rio 26504, Greece
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Pathological and mammographic prognostic factors for screen detected cancers in a multi-centre randomised, controlled trial of mammographic screening in women from age 40 to 48 years. Breast 2011; 20:525-8. [PMID: 21696957 DOI: 10.1016/j.breast.2011.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 01/29/2023] Open
Abstract
AIM To assess pathological and radiological prognostic factors for cancers detected by screening within a multi-centre RCT trial of mammographic screening of younger women. METHOD The survival of 232 women with screen detected invasive cancer was ascertained. Data on invasive cancer size, histological grade, nodal status, vascular invasion, mammographic spiculation, comedo calcification and mammographic background were assessed. Kaplan-Meier and Cox proportional hazards methods were used to examine survival. RESULTS Univariate analysis indicated that women with cancers with the following features had poorer survival; ≥ 30 mm, histologically grade 3, heavily node positive (4 or more positive nodes), vascular invasion positive and displaying mammographic comedo calcification. In a multivariate model survival remained poorer in women with four or more nodes positive (HR 8.36, 95% CI 2.31, 30.17) and in those with comedo calcification (HR 3.00,95% CI 1.13, 7.99). CONCLUSION Nodal status and the presence of mammographic comedo calcification have independent prognostic significance in young women with screen detected cancer.
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Karamouzis MV, Konstantinopoulos PA, Papavassiliou AG. Targeting MET as a strategy to overcome crosstalk-related resistance to EGFR inhibitors. Lancet Oncol 2009; 10:709-17. [PMID: 19573800 DOI: 10.1016/s1470-2045(09)70137-8] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The hepatocyte growth factor (HGF)-mesenchymal-epithelial transition factor (MET) pathway has a key role in carcinogenesis; it is implicated in proliferation, inhibition of apoptosis, angiogenesis, migration, invasiveness, and metastasis. All of these molecular events are driven through membrane and intracellular coplayers and several downstream effector proteins. MET has been shown to cross react with epithelial growth factor receptor (EGFR) proteins and possibly substitutes their activity, thus conferring resistance to EGFR-targeting drugs. Therefore, identification of MET inhibitors might lead to new treatments for MET-triggered neoplasia and improve the sensitivity of molecularly targeted antineoplastic compounds that are currently in use. In this Review, we outline current data regarding the HGF-MET pathway during carcinogenesis and the strategies for therapeutic targeting of this pathway. We also discuss the rationale and future perspectives of the combinatorial blockade of HGF-MET and EGFR signalling cascades in cancer treatment.
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Affiliation(s)
- Michalis V Karamouzis
- Department of Biological Chemistry, Medical School, University of Athens, Athens, Greece.
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Grivas PD, Antonacopoulou A, Tzelepi V, Sotiropoulou-Bonikou G, Kefalopoulou Z, Papavassiliou AG, Kalofonos H. HER-3 in colorectal tumourigenesis: from mRNA levels through protein status to clinicopathologic relationships. Eur J Cancer 2007; 43:2602-11. [PMID: 17920261 DOI: 10.1016/j.ejca.2007.08.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Accepted: 08/13/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Colorectal cancer is a major cause of cancer mortality in the Western world. Although HER-3 signalling is known to be implicated in colorectal carcinogenesis, the significance of its expression, localisation and phosphorylation remains elusive. METHODS Quantitative RT-PCR for HER-3 mRNA and immunohistochemistry for HER-3 and phosphorylated HER-3 (pHER-3) protein were performed in normal tissue, adenomas and carcinomas from 140 patients with colorectal cancer. RESULTS HER-3 was detected both in the cytoplasm and nucleus, whereas pHER-3 was observed in the nucleus and membrane of cells. A possible switch in HER-3 topography from the nucleus to the cytoplasm during colorectal tumourigenesis is suggested. The expression of pHER-3 did not differ significantly in normal tissue, adenomas and carcinomas, but was related to disease stage. HER-3 mRNA overexpression was significantly associated with decreased time to disease progression. It was also correlated with higher median age, left colon and rectal tumour sites and lymph node involvement. CONCLUSION We postulate that HER-3 is critically involved in colorectal tumourigenesis and its expression/phosphorylation might be of prognostic significance.
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Affiliation(s)
- Petros D Grivas
- Department of Internal Medicine, Medical School, University of Patras, 26504 Patras, Greece
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Karamouzis MV, Badra FA, Papavassiliou AG. Breast cancer: the upgraded role of HER-3 and HER-4. Int J Biochem Cell Biol 2006; 39:851-6. [PMID: 17254832 DOI: 10.1016/j.biocel.2006.11.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 11/23/2006] [Accepted: 11/30/2006] [Indexed: 10/23/2022]
Abstract
Breast cancer is the most common cancer in women and the ErbB receptor family holds crucial role in its pathogenesis. Among them, epidermal growth factor receptor and HER-2 are the most studied members and their overexpression has been associated with aggressive clinical behaviour. These data were further strengthened by the clinical success of trastuzumab, a monoclonal antibody against HER-2 in breast cancer patients with HER-2 overexpression and/or amplification. However, trastuzumab failure in some patients may partly be attributed to co-expression of other ErbB receptors. Herein, we provide updated views regarding the role of HER-3 and HER-4 in breast cancer. Accumulated evidence implies that these receptors should be considered more than heterodimerisation partners. Their expression profile might be useful in predicting responsiveness to current treatment options, while new strategies targeting their ligands and downstream effectors are being developed.
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Affiliation(s)
- Michalis V Karamouzis
- Department of Biological Chemistry, Medical School, University of Athens, 75, M. Asias Street, 11527 Athens, Greece
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