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Kim WY, Yang EJ, Jang EB, Lee AJ, So KA, Shim SH, Kim TJ, Lee SJ. The Expression and Amplification of HER2 Has a Significant Impact on the Prognosis of Endometrial Carcinoma in Korean Patients. J Clin Med 2024; 13:2158. [PMID: 38673431 PMCID: PMC11050345 DOI: 10.3390/jcm13082158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/25/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Objective: The purpose of this study was to analyze the protein overexpression and gene amplification of HER2 in endometrial carcinoma (EC) and to evaluate its role as a prognostic factor in Korean women. Methods: A tissue microarray (TMA) was constructed from samples from 191 patients with diverse histologic types of EC. HER2 protein expression and gene amplification status were analyzed using immunohistochemistry (IHC) and silver in situ hybridization (SISH), respectively. All patients were treated and followed up at a single tertiary medical center in Seoul, Korea, between July 2009 and October 2020. Results: In terms of histological type, among the 191 EC patients, 157 had endometrioid carcinoma, nine had uterine serous papillary carcinoma (USPC), one had clear cell carcinoma, one had squamous cell carcinoma, eight had mixed carcinoma, and 15 had uterine carcinosarcoma (UC). HER2 protein overexpression was observed in eight of the 191 (4.2%) EC patients; of these patients, five had IHC scores of 2+, and three had IHC scores of 3+. The HER2 overexpression rates of USPC, UC, and endometrioid carcinomas were 33.3%, 26.6%, and 0.6%, respectively. HER2 protein overexpression was significant in USPC and UC tissues (p < 0.000) and was associated with poor overall survival (OS) (p < 0.001). HER2 gene amplification was confirmed in seven of 184 patients (3.8%), including three patients with USPC and four patients with UC. OS was significantly shorter in patients who had HER2 amplification (p < 0.001). On multivariate analysis, HER2 expression and HER2 amplification were statistically significantly associated with worse OS (p = 0.006). However, HER2 expression without amplification was not statistically associated with OS (p = 0.993). Conclusions: HER2 protein overexpression and gene amplification are significantly correlated with shorter OS in Korean women. HER2 can be considered an important predictor of survival outcomes in EC patients.
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Affiliation(s)
- Wook Youn Kim
- Department of Pathology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea;
| | - Eun Jung Yang
- Department of Obstetrics and Gyneacology, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Republic of Korea;
| | - Eun Bi Jang
- Department of Obstetrics and Gynaecology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea; (E.B.J.); (A.J.L.); (K.A.S.); (S.-H.S.); (T.J.K.)
| | - A Jin Lee
- Department of Obstetrics and Gynaecology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea; (E.B.J.); (A.J.L.); (K.A.S.); (S.-H.S.); (T.J.K.)
| | - Kyeong A So
- Department of Obstetrics and Gynaecology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea; (E.B.J.); (A.J.L.); (K.A.S.); (S.-H.S.); (T.J.K.)
| | - Seung-Hyuk Shim
- Department of Obstetrics and Gynaecology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea; (E.B.J.); (A.J.L.); (K.A.S.); (S.-H.S.); (T.J.K.)
| | - Tae Jin Kim
- Department of Obstetrics and Gynaecology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea; (E.B.J.); (A.J.L.); (K.A.S.); (S.-H.S.); (T.J.K.)
| | - Sun Joo Lee
- Department of Obstetrics and Gynaecology, KonKuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Republic of Korea; (E.B.J.); (A.J.L.); (K.A.S.); (S.-H.S.); (T.J.K.)
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Eliahiai I, Eljiar M, Chaib S, KHarmoum J, Chraïbi M. [HER2 epidermal growth factor receptor, tests used to look for its amplification in breast cancer: Principles and limitations]. Bull Cancer 2023; 110:1301-1310. [PMID: 37858426 DOI: 10.1016/j.bulcan.2023.08.012] [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: 04/25/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 10/21/2023]
Abstract
HER2-positive breast cancer accounts for 20 % of all invasive breast cancers. It is associated with increased recurrence, a higher risk of brain metastases and a shorter overall survival than luminal A and B cancers. The presence of ERBB2 gene amplification is predictive of a good response to anti-HER2 therapies. Determining HER2 status is a hot topic, given recent studies on HER2-low subtypes. Although several techniques are available, the latest 2018 update from the American Society of Clinical Oncology and College of American Pathologists (ASCO/CAP) recommends a first immunohistochemical study followed by a fluorescence in situ hybridisation study indicated only for equivocal cases. This article summarises the different techniques used to determine HER2 status and provides a detailed review of the literature on pre-analytical factors and intrinsic tumour-specific factors that can distort or complicate the interpretation of results.
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Affiliation(s)
- Imane Eliahiai
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc.
| | - Mohammed Eljiar
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
| | - Sanae Chaib
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
| | - Jinane KHarmoum
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
| | - Mariame Chraïbi
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
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Memon R, Prieto Granada CN, Harada S, Winokur T, Reddy V, Kahn AG, Siegal GP, Wei S. Discordance Between Immunohistochemistry and In Situ Hybridization to Detect HER2 Overexpression/Gene Amplification in Breast Cancer in the Modern Age: A Single Institution Experience and Pooled Literature Review Study. Clin Breast Cancer 2021; 22:e123-e133. [PMID: 34120846 DOI: 10.1016/j.clbc.2021.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/26/2021] [Accepted: 05/08/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Human epidermal growth factor 2 (HER2) amplification and/or overexpression occurs in 12% to 25% of breast cancers. Accurate detection of HER2 is critical in predicting response to HER2-targeted therapy. Both immunohistochemistry (IHC) and in situ hybridization (ISH) are FDA-approved methods for detecting HER2 status because its protein overexpression is largely attributable to gene amplification. However, variable discordant results between IHC and ISH have been reported. METHODS We determined the frequency of HER2 IHC/ISH discordance in these patients and also performed a pooled literature review analysis. RESULTS Of the 1125 consecutive primary or metastatic breast cancers with HER2 IHC and ISH performed simultaneously between 2015 and 2020, 84.6% had an unequivocal HER2 status. Discordance was found in 30 cases from 26 patients, including 13 IHC-/ISH+ and 17 IHC+/ISH-, representing 1.6% and 11.9% of IHC- and IHC+ cases, respectively. Review of the literature between 2001 and 2020 identified 46 relevant studies, with a total of 43,468 cases with IHC and ISH performed. The IHC-/ISH+ and IHC+/ISH- discordances were seen in all antibody clones and ISH methods used. The IHC+/ISH- discordance was significantly higher than IHC-/ISH+ (13.8% vs. 3%, P < .0001). The overall discordance constituted 4% of all cases and 5.4% of those with an unequivocal IHC status. Significantly lower incongruities for both IHC-/ISH+ and IHC+/ISH- were found in those published after 2018. The discordances probably reflect altered biology of HER2 oncogene/oncoprotein. Routinely performing both IHC and ISH may uncover such cases to prevent denial of potentially beneficial targeted therapy.
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Affiliation(s)
| | | | - Shuko Harada
- Department of Pathology; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | - Gene P Siegal
- Department of Pathology; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Shi Wei
- Department of Pathology; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.
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Marshall DA, Grazziotin LR, Regier DA, Wordsworth S, Buchanan J, Phillips K, Ijzerman M. Addressing Challenges of Economic Evaluation in Precision Medicine Using Dynamic Simulation Modeling. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:566-573. [PMID: 32389221 PMCID: PMC7218800 DOI: 10.1016/j.jval.2020.01.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/08/2020] [Accepted: 01/26/2020] [Indexed: 05/17/2023]
Abstract
OBJECTIVES The objective of this article is to describe the unique challenges and present potential solutions and approaches for economic evaluations of precision medicine (PM) interventions using simulation modeling methods. METHODS Given the large and growing number of PM interventions and applications, methods are needed for economic evaluation of PM that can handle the complexity of cascading decisions and patient-specific heterogeneity reflected in the myriad testing and treatment pathways. Traditional approaches (eg, Markov models) have limitations, and other modeling techniques may be required to overcome these challenges. Dynamic simulation models, such as discrete event simulation and agent-based models, are used to design and develop mathematical representations of complex systems and intervention scenarios to evaluate the consequence of interventions over time from a systems perspective. RESULTS Some of the methodological challenges of modeling PM can be addressed using dynamic simulation models. For example, issues regarding companion diagnostics, combining and sequencing of tests, and diagnostic performance of tests can be addressed by capturing patient-specific pathways in the context of care delivery. Issues regarding patient heterogeneity can be addressed by using patient-level simulation models. CONCLUSION The economic evaluation of PM interventions poses unique methodological challenges that might require new solutions. Simulation models are well suited for economic evaluation in PM because they enable patient-level analyses and can capture the dynamics of interventions in complex systems specific to the context of healthcare service delivery.
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Affiliation(s)
- Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
| | - Luiza R Grazziotin
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Dean A Regier
- Alberta Cancer Control Research, BC Cancer, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Wordsworth
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK; National Institute for Health Research Oxford Biomedical Research Centre, Oxford, England, UK
| | - James Buchanan
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK; National Institute for Health Research Oxford Biomedical Research Centre, Oxford, England, UK
| | - Kathryn Phillips
- Center for Translational & Policy Research on Personalized Medicine, Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California at San Franciso, San Francisco, CA, USA
| | - Maarten Ijzerman
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands; Cancer Health Services Research, University of Melbourne Centre for Cancer Research, School of Population and Global Health, Melbourne, Australia
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Mehralikhani A, Movahedi M, Larypoor M, Golab F. Evaluation of the Effect of Foeniculum vulgare on the Expression of E-Cadherin, Dysadherin and Ki-67 in BALB/C Mice with 4T1 Model of Breast Cancer. Nutr Cancer 2020; 73:318-328. [PMID: 32266842 DOI: 10.1080/01635581.2020.1746365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Breast cancer is described as a serious disease and one of the important factors of cancer-related deaths. Considering the drug resistance, special attention has been paid to natural compounds. This study aimed at evaluating the anti-metastatic activity of fennel in a breast cancer mouse model.Methods: A total of 28 adult female BALB/C mice were used in this study. Breast cancer was induced by subcutaneous injection of 4T1 cells in the right lower flank. The mice received fennel extracts daily via intraperitoneal injection for two weeks. Meanwhile, tumor volume was measured every day using calipers. After two weeks, each animal was anesthetized. The expression levels of ki-67 and dysadherin as tumor markers, as well as E-cadherin as a tumor suppressor, were measured in tumor tissue and ovary. Also the expression of her2 was measured in ovary.Results: Tumor size significantly decreased after nine days treatment of the fennel. Fennel treatment caused an increase in the ratio of the expression of E-cadherin to Ki-67 and dysadherin in the tumor tissues. On the other hand, the expression of Ki-67 and HER2 decreased in the ovary.Conclusion: Based on our findings, fennel has anti-tumor and anti-metastatic activities against aggressive cancers.
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Affiliation(s)
| | - Monireh Movahedi
- Department of Biochemistry, Islamic Azad University, Tehran, Iran
| | | | - Fereshteh Golab
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
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