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Zhao S, Wang Y, Zhou A, Liu X, Zhang Y, Zhang J. Neoadjuvant chemotherapy efficacy and prognosis in HER2-low and HER2-zero breast cancer patients by HR status: a retrospective study in China. PeerJ 2024; 12:e17492. [PMID: 38827304 PMCID: PMC11143972 DOI: 10.7717/peerj.17492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024] Open
Abstract
Background The promising efficacy of novel anti-HER2 antibody-drug conjugates (ADC) in HER2-low breast cancer has made HER2-low a research hotspot. However, controversy remains regarding the neoadjuvant chemotherapy (NAC) efficacy, prognosis, and the relationship with hormone receptor (HR) status of HER2-low. Methods A retrospective analysis was conducted on 975 patients with HER2-negative breast cancer undergoing NAC at Tianjin Medical University Cancer Institute and Hospital, evaluating pathological complete response (pCR) rate and prognosis between HER2-low and HER2-zero in the overall cohort and subgroups. Results Overall, 579 (59.4%) and 396 (40.6%) patients were HER2-low and HER2-zero disease, respectively. Compared with HER2-zero, the HER2-low cohort consists of more postmenopausal patients, with lower histological grade and higher HR positivity. In the HR-positive subgroup, HER2-low cases remain to exhibit lower histological grade, while in the HR-negative subgroup, they show higher grade. The HER2-low group had lower pCR rates than the HER2-zero group (16.4% vs. 24.0%). In the HR-positive subgroup, HER2-low consistently showed lower pCR rate (8.1% vs. 15.5%), and served as an independent suppressive factor for the pCR rate. However, no significant difference was observed in the pCR rates between HER2-low and HER2-zero in the HR-negative breast cancer. In the entire cohort and in stratified subgroups based on HR and pCR statuses, no difference in disease-free survival were observed between HER2-low and HER2-zero. Conclusions In the Chinese population, HER2-low breast cancer exhibits distinct characteristics and efficacy of NAC in different HR subgroups. Its reduced pCR rate in HR-positive subgroup is particularly important for clinical decisions. However, HER2-low is not a reliable factor for assessing long-term survival outcomes.
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Affiliation(s)
- Shaorong Zhao
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yuyun Wang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Angxiao Zhou
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xu Liu
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yi Zhang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jin Zhang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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Zhang Y, Zhu M, Zhu J, Xu F, Chen Y. Nanoproteomics deciphers the prognostic value of EGFR family proteins-based liquid biopsy. Anal Biochem 2023; 671:115133. [PMID: 37011758 DOI: 10.1016/j.ab.2023.115133] [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: 09/28/2022] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 04/04/2023]
Abstract
Monitoring tumor-associated protein status in serum can effectively track tumors and avoid time-consuming, costly, and invasive tissue biopsy. Epidermal growth factor receptor (EGFR) family proteins are often recommended in the clinical management of multiple solid tumors. However, the low-abundance of serum EGFR (sEGFR) family proteins hinders the depth-understanding of their function and tumor management. Herein, a nanoproteomics approach coupling with aptamer-modified MOFs (NMOFs-Apt) with mass spectrometry was developed for the enrichment and quantitative analysis of sEGFR family proteins. This nanoproteomics approach exhibited high sensitivity and specificity for sEGFR family protein quantification, with the limit of quantification as low as 1.00 nM. After detecting 626 patients' sEGFR family proteins with various malignant tumors, we concluded that the levels of serum proteins had a moderate concordance with tissue counterparts. Metastatic breast cancer patients with a high level of serum human epidermal growth factor receptor 2 (sHER2) and a low level of sEGFR had a poor prognosis, and patients with a sHER2 decrease of more than 20% had longer disease-free time after receiving chemotherapy. This nanoproteomics method provided a simple and effective approach for low-abundant serum protein detection and our results clarified the potential of sHER2 and sEGFR as cancer markers.
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Affiliation(s)
- Yuanyuan Zhang
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Mingchen Zhu
- Department of Clinical Laboratory, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, 210009, China
| | - Jianhua Zhu
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Feifei Xu
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Yun Chen
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China; State Key Laboratory of Reproductive Medicine, 210029, China; Key Laboratory of Cardiovascular & Cerebrovascular Medicine, Nanjing, 210029, China.
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Prognostic Value of the Serum HER2 Extracellular Domain Level in Breast Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14194551. [PMID: 36230471 PMCID: PMC9559205 DOI: 10.3390/cancers14194551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022] Open
Abstract
An elevated serum HER2 extracellular domain is associated with poor prognosis in breast cancer, but the relationship between sHER2 and the efficacy of different modalities remains controversial. Herein, we aimed to evaluate the prognostic value of serum HER2 extracellular domain (sHER2 ECD) in breast cancer and to identify its correlation with the efficacy of different treatment regimens. A systematic search of the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases was conducted to identify studies exploring the association between HER2 ECD level and clinical outcomes among patients with breast cancer. Using the random effects models, pooled hazard ratios (HRs), and odds ratios (ORs) with 95% confidence intervals (CI), were calculated for progression-free survival (PFS), overall survival (OS), disease-free survival (DFS), and the objective response rate (ORR). Heterogeneity was further evaluated by subgroup and sensitivity analysis. Overall, 40 studies comprising 12,229 patients were included in this systematic review and meta-analysis. Elevated HER2 ECD levels were associated with worse PFS (HR 1.74, 95% CI 1.40−2.17; p < 0.001), and this effect was observed in patients treated with chemotherapy (HR 1.81, 95% CI 1.37−2.39; p < 0.001), endocrine therapy (HR 1.91, 95% CI 1.57−2.32; p < 0.001), and trastuzumab (HR 1.74, 95% CI 1.31−2.30; p < 0.001). However, this association was not present in patients treated with tyrosine kinase inhibitors (TKIs) (HR 1.44, 95% CI 0.85−2.43, p = 0.17). The HRs/ORs for an elevated HER2 ECD level for DFS, OS, and ORR were 2.73 (95% CI 2.17−3.42; p < 0.001), 2.13 (95% CI 1.77−2.57; p < 0.001), and 0.80 (95% CI 0.49−1.31; p = 0.381), respectively. An elevated sHER2 ECD was an unfavorable prognostic factor in breast cancer but did not affect the efficacy of tyrosine kinase inhibitors such as lapatinib. Detection of sHER2 ECD may be helpful for clinicians selecting the appropriate anti-HER2 therapy for patients with HER2-positive breast cancer.
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Moku P, Shepherd L, Ali SM, Leitzel K, Parulekar WR, Zhu L, Virk S, Nomikos D, Aparicio S, Gelmon K, Drabick J, Cream L, Halstead ES, Umstead TM, Mckeone D, Polimera H, Maddukuri A, Ali A, Nagabhairu V, Poulose J, Pancholy N, Spiegel H, Chen BE, Lipton A. Higher serum PD-L1 level predicts increased overall survival with lapatinib versus trastuzumab in the CCTG MA.31 phase 3 trial. Cancer 2020; 126:4859-4866. [PMID: 32910476 DOI: 10.1002/cncr.33149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/18/2020] [Accepted: 06/26/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this retrospective biomarker study of the Canadian Cancer Trials Group (CCTG) MA.31 randomized phase 3 trial (lapatinib vs trastuzumab) of HER2-positive metastatic breast cancer (MBC) was to evaluate the prognostic and predictive biomarker utility of pretreatment serum programmed death ligand 1 (PD-L1) levels. METHODS CCTG MA.31 accrued 652 HER2-positive patients; 387 had serum available (185 in the trastuzumab arm and 202 in the lapatinib arm). The Ella immunoassay platform (ProteinSimple, San Jose, California) was used to quantitate serum PD-L1 levels. Stepwise forward Cox multivariable analyses were performed for progression-free survival and overall survival (OS). RESULTS In the whole trial population, continuous pretreatment serum PD-L1 levels were not associated with OS. However, within the trastuzumab arm, a higher continuous pretreatment serum PD-L1 level was significant for shorter OS (hazard ratio [HR], 3.85; P = .04), but within the lapatinib arm, pretreatment serum PD-L1 was not associated with OS (P = .37). In the whole trial, in a multivariable analysis for OS, serum PD-L1 (median cut point) remained a significant independent covariate (HR, 2.38; P = .001). There was a significant interaction between treatment arm and continuous serum PD-L1 (bootstrap method; P = .0025): at or above 214.2 pg/mL (the 89th percentile), serum PD-L1 was associated with significantly shorter OS with trastuzumab treatment versus lapatinib treatment. CONCLUSIONS In the CCTG MA.31 trial, serum PD-L1 was a significant predictive factor: a higher pretreatment serum PD-L1 level was associated with shorter OS with trastuzumab treatment but with longer OS with lapatinib treatment. Immune evasion may decrease the effectiveness of trastuzumab therapy. Further evaluation of elevated serum PD-L1 in advanced breast cancer is warranted to identify patients with HER2-positive MBC who may benefit from novel immune-targeted therapies in addition to trastuzumab.
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Affiliation(s)
- Prashanth Moku
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Lois Shepherd
- Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada
| | - Suhail M Ali
- Penn State Hershey Medical Center, Hershey, Pennsylvania.,Lebanon VA Medical Center, Lebanon, Pennsylvania
| | - Kim Leitzel
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Wendy R Parulekar
- Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada
| | - Liting Zhu
- Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada
| | - Shakeel Virk
- Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada
| | - Dora Nomikos
- Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada
| | - Samuel Aparicio
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Karen Gelmon
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Joe Drabick
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Leah Cream
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Todd M Umstead
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Dan Mckeone
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Hyma Polimera
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Aamnah Ali
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Joyson Poulose
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Neha Pancholy
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Bingshu E Chen
- Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada
| | - Allan Lipton
- Penn State Hershey Medical Center, Hershey, Pennsylvania
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Ulaner GA, Carrasquillo JA, Riedl CC, Yeh R, Hatzoglou V, Ross DS, Jhaveri K, Chandarlapaty S, Hyman DM, Zeglis BM, Lyashchenko SK, Lewis JS. Identification of HER2-Positive Metastases in Patients with HER2-Negative Primary Breast Cancer by Using HER2-targeted 89Zr-Pertuzumab PET/CT. Radiology 2020; 296:370-378. [PMID: 32515679 DOI: 10.1148/radiol.2020192828] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Human epidermal growth factor receptor 2 (HER2)-targeted therapies are successful in patients with HER2-positive malignancies; however, spatial and temporal heterogeneity of HER2 expression may prevent identification of optimal patients for these therapies. Purpose To determine whether imaging with the HER2-targeted PET tracer zirconium 89 (89Zr)-pertuzumab can depict HER2-positive metastases in women with HER2-negative primary breast cancer. Materials and Methods From January to June 2019, women with biopsy-proven HER2-negative primary breast cancer and biopsy-proven metastatic disease were enrolled in a prospective clinical trial (ClinicalTrials.gov NCT02286843) and underwent 89Zr-pertuzumab PET/CT for noninvasive whole-biopsy evaluation of potential HER2-positive metastases. 89Zr-pertuzumab-avid foci that were suspicious for HER2-positive metastases were tissue sampled and examined by pathologic analysis to document HER2 status. Results Twenty-four women (mean age, 55 years ± 11 [standard deviation]) with HER2-negative primary breast cancer were enrolled. Six women demonstrated foci at 89Zr-pertuzumab PET/CT that were suspicious for HER2-positive disease. Of these six women, three had biopsy-proven HER2-positive metastases, two had pathologic findings that demonstrated HER2-negative disease, and one had a fine-needle aspirate with inconclusive results. Conclusion Human epidermal growth factor receptor 2 (HER2)-targeted imaging with zirconium 89-pertuzumab PET/CT was successful in detecting HER2-positive metastases in women with HER2-negative primary breast cancer. This demonstrates the ability of targeted imaging to identify patients for targeted therapies that might not otherwise be considered. © RSNA, 2020 Online supplemental material is available for this article. See the editorial by Mankoff and Pantel in this issue.
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Affiliation(s)
- Gary A Ulaner
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Jorge A Carrasquillo
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Christopher C Riedl
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Randy Yeh
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Vaios Hatzoglou
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Dara S Ross
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Komal Jhaveri
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Sarat Chandarlapaty
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - David M Hyman
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Brian M Zeglis
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Serge K Lyashchenko
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
| | - Jason S Lewis
- From the Department of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., B.M.Z., S.K.L., J.S.L.), Department of Pathology (D.S.R.), Department of Medicine (K.J., S.C., D.M.H.), and Molecular Pharmacology Program (B.M.Z., J.S.L.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065; Departments of Radiology (G.A.U., J.A.C., C.C.R., R.Y., V.H., S.K.L., J.S.L.) and Medicine (K.J., S.C., D.M.H.), Weill Cornell Medical College, New York, NY; and Department of Chemistry, Hunter College, City University of New York, New York, NY (B.M.Z.)
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Perrier A, Boelle PY, Chrétien Y, Gligorov J, Lotz JP, Brault D, Comperat E, Lefèvre G, Boissan M. An updated evaluation of serum sHER2, CA15.3, and CEA levels as biomarkers for the response of patients with metastatic breast cancer to trastuzumab-based therapies. PLoS One 2020; 15:e0227356. [PMID: 31910438 PMCID: PMC6946590 DOI: 10.1371/journal.pone.0227356] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022] Open
Abstract
Background The transmembrane receptor tyrosine kinase HER2 is overexpressed in approximately 15% of breast tumors and correlates with poor clinical prognosis. Several treatments that target HER2 are approved for treatment of HER2-positive metastatic breast cancer. The serum biomarkers most widely used to monitor anti-HER2 therapies in patients with HER2-positive metastatic breast cancer currently are CA15.3 and CEA. Nevertheless, their clinical utility in patients with breast cancer remains a subject of discussion and controversy; thus, additional markers may prove useful in monitoring the therapeutic responses of these patients. The extracellular domain of HER2 can be shed by proteolytic cleavage into the circulation and this shed form, sHER2, is reported to be augmented during metastasis of HER2-positive breast tumors. Here, we studied the clinical usefulness of sHER2, CA15.3, and CEA for monitoring treatment for breast cancer. Methods We measured prospectively pretreatment and post-treatment serum levels (day 1, 30, 60 and 90) of these three biomarkers in 47 HER2-positive, metastatic breast cancer patients treated with trastuzumab in combination with paclitaxel. Evaluation of the disease was performed according to the Response Evaluation Criteria in Solid Tumor (RECIST) at day 90. Results Patients with progressive disease at day 90 had smaller relative changes between day 1 and day 30 than those with complete, partial or stable responses at day 90: -9% versus -38% for sHER2 (P = 0.02), +23% versus -17% for CA15.3 (P = 0.005) and +29% versus -26% for CEA (P = 0.02). Patients with progressive disease at day 90 were less likely than the other patients to have a relative decrease of > 20% in their biomarker levels at day 30: 6% vs 33% for sHER2 (P = 0.03), 0% vs 27% for CA15.3 (P = 0.03), 4% vs 29% for CEA (P = 0.04). No patient with progressive disease at day 90 had > 20% reduction of the average combined biomarker levels at day 30 whereas 63% of the other patients had (P = 0.003). Moreover, when we analyzed a > 10% reduction of the average biomarker levels no patient with progressive disease at day 90 had a decrease > 10% at day 30 whereas 78% of other patients had (P<0.001, Se = 100%, Sp = 78%). Conclusion We show that regular measurement of sHER2, CA15.3, and CEA levels is useful for predicting the therapeutic response and for monitoring HER2-targeted therapy in patients with HER2-positive metastatic breast cancer. The average decrease of the three biomarkers with a threshold of > 10% appears to be the best parameter to distinguish patients who go on to have progressive disease from those who will have a complete, partial or stable response.
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Affiliation(s)
- Alexandre Perrier
- Laboratoire de Biochimie et Hormonologie, Hôpital Tenon, Groupe Hospitalier Est Parisien, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Pierre-Yves Boelle
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Assistance Publique–Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Yves Chrétien
- Centre de Recherche Saint-Antoine, INSERM, Sorbonne Université, Paris, France
| | - Joseph Gligorov
- Service d’Oncologie Médicale, Institut Universitaire de Cancérologie APHP–Sorbonne Université, Paris, France
| | - Jean-Pierre Lotz
- Service d’Oncologie Médicale, Institut Universitaire de Cancérologie APHP–Sorbonne Université, Paris, France
| | - Didier Brault
- Laboratoire de Biochimie et Hormonologie, Hôpital Tenon, Groupe Hospitalier Est Parisien, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Eva Comperat
- Department of Pathology, Hôpital Tenon, Groupe Hospitalier Est Parisien, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Guillaume Lefèvre
- Laboratoire de Biochimie et Hormonologie, Hôpital Tenon, Groupe Hospitalier Est Parisien, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Mathieu Boissan
- Laboratoire de Biochimie et Hormonologie, Hôpital Tenon, Groupe Hospitalier Est Parisien, Assistance Publique–Hôpitaux de Paris, Paris, France
- Centre de Recherche Saint-Antoine, INSERM, Sorbonne Université, Paris, France
- * E-mail:
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7
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Preclinical Characteristics of the Irreversible Pan-HER Kinase Inhibitor Neratinib Compared with Lapatinib: Implications for the Treatment of HER2-Positive and HER2-Mutated Breast Cancer. Cancers (Basel) 2019; 11:cancers11060737. [PMID: 31141894 PMCID: PMC6628314 DOI: 10.3390/cancers11060737] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/13/2022] Open
Abstract
An estimated 15–20% of breast cancers overexpress human epidermal growth factor receptor 2 (HER2/ERBB2/neu). Two small-molecule tyrosine kinase inhibitors (TKIs), lapatinib and neratinib, have been approved for the treatment of HER2-positive (HER2+) breast cancer. Lapatinib, a reversible epidermal growth factor receptor (EGFR/ERBB1/HER1) and HER2 TKI, is used for the treatment of advanced HER2+ breast cancer in combination with capecitabine, in combination with trastuzumab in patients with hormone receptor-negative metastatic breast cancer, and in combination with an aromatase inhibitor for the first-line treatment of HER2+ breast cancer. Neratinib, a next-generation, irreversible pan-HER TKI, is used in the US for extended adjuvant treatment of adult patients with early-stage HER2+ breast cancer following 1 year of trastuzumab. In Europe, neratinib is used in the extended adjuvant treatment of adult patients with early-stage hormone receptor-positive HER2+ breast cancer who are less than 1 year from the completion of prior adjuvant trastuzumab-based therapy. Preclinical studies have shown that these agents have distinct properties that may impact their clinical activity. This review describes the preclinical characterization of lapatinib and neratinib, with a focus on the differences between these two agents that may have implications for patient management.
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8
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Ding Y, Wang H, Zheng H, Wang L, Zhang G, Yang J, Lu X, Bai Y, Zhang H, Li J, Gao W, Chen F, Hu S, Wu J, Xu L. Evaluation of drug efficacy based on the spatial position comparison of drug–target interaction centers. Brief Bioinform 2019; 21:762-776. [DOI: 10.1093/bib/bbz024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/28/2019] [Accepted: 02/09/2019] [Indexed: 02/06/2023] Open
Abstract
Abstract
The spatial position and interaction of drugs and their targets is the most important characteristics for understanding a drug’s pharmacological effect, and it could help both in finding new and more precise treatment targets for diseases and in exploring the targeting effects of the new drugs. In this work, we develop a computational pipeline to confirm the spatial interaction relationship of the drugs and their targets and compare the drugs’ efficacies based on the interaction centers. First, we produce a 100-sample set to reconstruct a stable docking model of the confirmed drug–target pairs. Second, we set 5.5 Å as the maximum distance threshold for the drug–amino acid residue atom interaction and construct 3-dimensional interaction surface models. Third, by calculating the spatial position of the 3-dimensional interaction surface center, we develop a comparison strategy for estimating the efficacy of different drug–target pairs. For the 1199 drug–target interactions of the 649 drugs and 355 targets, the drugs that have similar interaction center positions tend to have similar efficacies in disease treatment, especially in the analysis of the 37 targeted relationships between the 15 known anti-cancer drugs and 10 target molecules. Furthermore, the analysis of the unpaired anti-cancer drug and target molecules suggests that there is a potential application for discovering new drug actions using the sampling molecular docking and analyzing method. The comparison of the drug–target interaction center spatial position method better reflect the drug–target interaction situations and could support the discovery of new efficacies among the known anti-cancer drugs.
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Affiliation(s)
- Yu Ding
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Hong Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, P. R. China
| | - Hewei Zheng
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Lianzong Wang
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Guosi Zhang
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Jiaxin Yang
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Xiaoyan Lu
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Yu Bai
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Haotian Zhang
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Jing Li
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Wenyan Gao
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Fukun Chen
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Shui Hu
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Jingqi Wu
- Harbin Medical University, Harbin, P. R. China
- Wenzhou Medical University, Wenzhou
| | - Liangde Xu
- School of Ophthalmology & Optometry and Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou
- Training Center for Students Innovation and Entrepreneurship Education, Harbin Medical University, Harbin
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9
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The extracellular domain of Her2 in serum as a biomarker of breast cancer. J Transl Med 2018; 98:696-707. [PMID: 29491426 DOI: 10.1038/s41374-018-0033-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 11/08/2022] Open
Abstract
Breast cancer is a major health problem worldwide. In ~15% of breast cancers, the epidermal growth factor receptor HER2, a transmembrane protein, is overexpressed. This HER2 overexpression is associated with an aggressive form of the disease and a poor clinical prognosis. The extracellular domain (ECD) of HER2 is released into the blood by a proteolytic mechanism known as "ECD shedding". This proteolytic shedding leaves a constitutively active truncated receptor in the membrane that is 10-100-fold more oncogenic than the full-length receptor and promotes the growth and survival of cancer cells. Shedding of the HER2 ECD is increased during metastasis: whereas 15% of primary breast cancer patients have elevated levels of serum HER2 ECD (sHER2 ECD), the levels reach 45% in patients with metastatic disease. Thus, sHER2 ECD has been proposed as a promising biomarker for cancer recurrence and for monitoring the disease status of patients overexpressing HER2. Nevertheless, in 2016, the American Society of Clinical Oncology advises clinicians not to use soluble HER2 levels to guide their choice of adjuvant therapy for patients with HER2-positive breast cancer, because the evidence was considered not strong enough. Currently, biomarkers such as carcinoembryonic antigen and cancer antigen 15-3 are widely used to monitor metastatic breast cancer disease even if the level of evidence of clinical impact of this monitoring is poor. In this article, we review the evidence that sHER2 ECD might be used in some situations as a biomarker for breast cancer. Although this serum biomarker will not replace the direct measurement of tumor HER2 status for diagnosis of early-stage tumors; it might be especially useful in metastatic disease for prognosis, as an indicator of cancer progression and of therapy response, particularly to anti-HER2 therapies. Owing to these data, sHER2 ECD should be considered as a promising biomarker to detect cancer recurrence and metastasis.
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10
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Duffy MJ, McDermott EW, Crown J. Blood-based biomarkers in breast cancer: From proteins to circulating tumor cells to circulating tumor DNA. Tumour Biol 2018; 40:1010428318776169. [DOI: 10.1177/1010428318776169] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Biomarkers are the key to personalized treatment in patients with breast cancer. While tissue biomarkers are most useful in determining prognosis and upfront predicting response to therapy, circulating protein biomarkers such as CA 15-3 and carcinoembryonic antigen are mainly used in monitoring response to endocrine or chemotherapy in patients with advanced disease. Although several centers measure biomarkers in asymptomatic patients following curative surgery for primary breast cancer, the clinical utility of this practice is unclear. Promising new biomarkers for breast cancer include circulating tumor DNA and circulating tumor cells. In contrast to circulating protein biomarkers, measurement of circulating tumor DNA–based biomarkers is potentially useful in identifying mechanisms of resistance to ongoing therapies as well as identifying new targets for further treatment. To increase clinical utility, both the established and emerging circulating biomarkers should where possible be incorporated into randomized trials evaluating new therapies in patients with breast cancer.
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Affiliation(s)
- Michael J Duffy
- Clinical Research Centre, St. Vincent’s University Hospital, Dublin, Ireland
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Enda W McDermott
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - John Crown
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- Department of Medical Oncology, St Vincent’s University Hospital, Dublin, Ireland
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11
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Chen J, Xu J, Li Y, Zhang J, Chen H, Lu J, Wang Z, Zhao X, Xu K, Li Y, Li X, Zhang Y. Competing endogenous RNA network analysis identifies critical genes among the different breast cancer subtypes. Oncotarget 2018; 8:10171-10184. [PMID: 28052038 PMCID: PMC5354650 DOI: 10.18632/oncotarget.14361] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/15/2016] [Indexed: 01/10/2023] Open
Abstract
Although competing endogenous RNAs (ceRNAs) have been implicated in many solid tumors, their roles in breast cancer subtypes are not well understood. We therefore generated a ceRNA network for each subtype based on the significance of both, positive co-expression and the shared miRNAs, in the corresponding subtype miRNA dys-regulatory network, which was constructed based on negative regulations between differentially expressed miRNAs and targets. All four subtype ceRNA networks exhibited scale-free architecture and showed that the common ceRNAs were at the core of the networks. Furthermore, the common ceRNA hubs had greater connectivity than the subtype-specific hubs. Functional analysis of the common subtype ceRNA hubs highlighted factors involved in proliferation, MAPK signaling pathways and tube morphogenesis. Subtype-specific ceRNA hubs highlighted unique subtype-specific pathways, like the estrogen response and inflammatory pathways in the luminal subtypes or the factors involved in the coagulation process that participates in the basal-like subtype. Ultimately, we identified 29 critical subtype-specific ceRNA hubs that characterized the different breast cancer subtypes. Our study thus provides new insight into the common and specific subtype ceRNA interactions that define the different categories of breast cancer and enhances our understanding of the pathology underlying the different breast cancer subtypes, which can have prognostic and therapeutic implications in the future.
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Affiliation(s)
- Juan Chen
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Juan Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Yongsheng Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Jinwen Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Hong Chen
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Jianping Lu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Zishan Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Xueying Zhao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Kang Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Yixue Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Xia Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Yan Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
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12
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Duchnowska R, Sperinde J, Czartoryska-Arłukowicz B, Myśliwiec P, Winslow J, Radecka B, Petropoulos C, Demlova R, Orlikowska M, Kowalczyk A, Lang I, Ziółkowska B, Dębska-Szmich S, Merdalska M, Grela-Wojewoda A, Żawrocki A, Biernat W, Huang W, Jassem J. Predictive value of quantitative HER2, HER3 and p95HER2 levels in HER2-positive advanced breast cancer patients treated with lapatinib following progression on trastuzumab. Oncotarget 2017; 8:104149-104159. [PMID: 29262628 PMCID: PMC5732794 DOI: 10.18632/oncotarget.22027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/21/2017] [Indexed: 12/27/2022] Open
Abstract
Lapatinib is a HER1 and HER2 tyrosine kinase inhibitor (TKI) approved in second line treatment of advanced or metastatic breast cancer following progression on trastuzumab-containing therapy. Biomarkers for activity of lapatinib and other TKIs are lacking. Formalin-fixed, paraffin-embedded primary tumor samples were obtained from 189 HER2-positive patients treated with lapatinib plus capecitabine following progression on trastuzumab. The HERmark® Breast Cancer Assay was used to quantify HER2 protein expression. HER3 and p95HER2 protein expression was quantified using the VeraTag® technology. Overall survival (OS) was inversely correlated with HER2 (HR = 1.9/log; P = 0.009) for patients with tumors above the cut-off positivity level by the HERmark assay. OS was significantly shorter for those with above median HER2 levels (HR = 1.7; P = 0.015) and trended shorter for those below the cut-off level of positivity by the HERmark assay (HR = 1.7; P = 0.057) compared to cases with moderate HER2 overexpression. The relationship between HER2 protein expression and OS was best captured with a U-shaped parabolic function (P = 0.004), with the best prognosis at moderate levels of HER2 protein overexpression. In a multivariate model including HER2, increasing p95HER2 expression was associated with longer OS (HR = 0.35/log; P = 0.027). Continuous HER3 did not significantly correlate with OS. Patients with moderately overexpressed HER2 levels and high p95HER2 expression may have best outcomes while receiving lapatinib following progression on trastuzumab. Further study is warranted to explore the predictive utility of quantitative HER2 and p95HER2 in guiding HER2-directed therapies.
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Affiliation(s)
| | - Jeff Sperinde
- Monogram Biosciences, Integrated Oncology, Laboratory Corporation of America Holdings, South San Francisco, CA, USA
| | | | | | - John Winslow
- Monogram Biosciences, Integrated Oncology, Laboratory Corporation of America Holdings, South San Francisco, CA, USA
| | | | - Christos Petropoulos
- Monogram Biosciences, Integrated Oncology, Laboratory Corporation of America Holdings, South San Francisco, CA, USA
| | | | | | | | - Istvan Lang
- National Institute of Oncology, Budapest, Hungary
| | | | | | | | | | | | | | - Weidong Huang
- Monogram Biosciences, Integrated Oncology, Laboratory Corporation of America Holdings, South San Francisco, CA, USA
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13
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Impact of serum HER2, TIMP-1, and CAIX on outcome for HER2+ metastatic breast cancer patients: CCTG MA.31 (lapatinib vs. trastuzumab). Breast Cancer Res Treat 2017; 164:571-580. [DOI: 10.1007/s10549-017-4273-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/29/2017] [Indexed: 01/07/2023]
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14
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Sonnenblick A, Pondé N, Piccart M. Metastatic breast cancer: The Odyssey of personalization. Mol Oncol 2016; 10:1147-59. [PMID: 27430154 PMCID: PMC5423195 DOI: 10.1016/j.molonc.2016.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/27/2016] [Accepted: 07/05/2016] [Indexed: 12/31/2022] Open
Abstract
Metastatic breast cancer is the most frequent cause of cancer death for women worldwide. In the last 15 years, a large number of new agents have entered clinical use, a result of the dramatic increase in our understanding of the molecular underpinnings of metastatic breast cancer. However, while these agents have led to better outcomes, they are also at the root cause of increasing financial pressure on healthcare systems. Moreover, decision making in an era where every year new agents are added to the therapeutic armamentarium has also become a significant challenge for medical oncologists. In the present article, we will provide an ample review on the most recent developments in the field of treatment of the different subtypes of metastatic breast cancer with a critical discussion on the slow progress made in identifying response biomarkers. New hopes in the form of ctDNA monitoring and functional imaging will be presented.
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Affiliation(s)
- A Sonnenblick
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 125, B 1000 Brussels, Belgium; Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - N Pondé
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 125, B 1000 Brussels, Belgium
| | - M Piccart
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 125, B 1000 Brussels, Belgium.
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15
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Darlix A, Lamy PJ, Lopez-Crapez E, Braccini AL, Firmin N, Romieu G, Thezenas S, Jacot W. Serum HER2 extra-cellular domain, S100ß and CA 15-3 levels are independent prognostic factors in metastatic breast cancer patients. BMC Cancer 2016; 16:428. [PMID: 27387327 PMCID: PMC4937557 DOI: 10.1186/s12885-016-2448-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/20/2016] [Indexed: 01/28/2023] Open
Abstract
Background Metastatic breast cancer (MBC) prognosis is highly variable, depending on various factors such as the biological subtype, the performance status, disease extension…. A better evaluation of a patient’s prognostic factors could allow for a more accurate choice of treatments. The role of serum tumor markers remains, however, unclear in this population. Considering the recent interest in phenotypic changes and tumor heterogeneity during breast cancer progression, additional tumor markers could be interesting in this setting. Methods Two hundred fifty MBC patients treated at the Montpellier Cancer Institute (2008–2015) were retrospectively selected, based on the availability of frozen serum samples. The usual MBC clinical and pathological variables were collected, altogether with Cancer Antigen 15-3 (CA15-3), Carcinoembryonic Antigen (CEA), HER2 extra-cellular domain (ECD), Neuron Specific Enolase (NSE), S100ß protein and Matrix Metalloproteinase 9 (MMP-9) serum levels in order to determine their prognostic value. Results With a median follow-up of 40.8 months, median overall survival was 16.2 months (95 % CI 12.4–20.6). In multivariate analysis, the performance status, brain or subcutaneous metastases, the number of previous metastatic chemotherapy lines and the tumor biological subtype were independent prognostic factors. Elevated CA 15-3 (HR = 1.95, IC 95 % 1.31–2.93, p = 0.001), HER2 ECD (regardless of tumor HER2 status, HR = 2.51, IC 95 % 1.53–4.12, p < 0.001) and S100ß (HR = 1.93, IC 95 % 1.05–3.54, p = 0.033) serum levels were independently associated with a poor outcome. Conclusions Serum CA 15-3, HER2 ECD and S100ß could represent useful independent prognostic factors in MBC. Of particular interest is the independent value of serum HER2 ECD levels, regardless of the tumor HER2 status, possibly linked to metastatic tumor heterogeneity.
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Affiliation(s)
- Amélie Darlix
- Department of Medical Oncology, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France.
| | - Pierre-Jean Lamy
- Department of Clinical Research, Clinique Beausoleil, 19 Avenue de Lodève, 34070, Montpellier, France.,Department of Biology and Oncogenetic, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France
| | - Evelyne Lopez-Crapez
- Translational Research Unit, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France
| | | | - Nelly Firmin
- Department of Medical Oncology, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France
| | - Gilles Romieu
- Department of Medical Oncology, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France
| | - Simon Thezenas
- Biometrics unit, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France
| | - William Jacot
- Department of Medical Oncology, Institut régional du Cancer de Montpellier, 208 rue des apothicaires, 34298, Montpellier, France
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16
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Wang T, Zhou J, Zhang S, Bian L, Hu H, Xu C, Hao X, Liu B, Ye Q, Liu Y, Jiang Z. Meaningful interpretation of serum HER2 ECD levels requires clear patient clinical background, and serves several functions in the efficient management of breast cancer patients. Clin Chim Acta 2016; 458:23-9. [PMID: 27109901 DOI: 10.1016/j.cca.2016.04.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study was initiated to evaluate the clinical significant of HER2 extracellular domain (ECD) in the real-time management of breast cancer patients. METHODS Five-hundred forty-six eligible breast cancer patients were divided according to their clinical background. The correlation between ECD, tissue HER2, and clinical outcome of the patients were analyzed. RESULTS Receiver operating characteristic analysis revealed that ECD measured before receiving neoadjuvant therapy yielded the highest area under the curve (0.9185; P<0.0001), indicating that ECD and tissue HER2 levels are consistent in untreated tumor-bearing patients. At cut-off of 15.0ng/ml, the prognostic value of ECD was demonstrated using univariate (HR=1.664, P<0.0001) and multivariate (HR=1.547, P=0.011) Cox regression analysis. Kaplan-Meier survival curves revealed that patients with elevated ECD had shorter progression-free survival (PFS) (4.0 vs. 6.1months, P<0.0001). Elevated ECD was also an adverse predictor for PFS in response to anti-HER2 therapy (4.3 vs. 10.2months, P=0.0155). In contrast, ≥20%, decreased ECD was associated with longer PFS in patients who received anti-HER2 therapy (10.9 vs. 2.4months, P=0.0164) and overall (10.7 vs. 2.8months, P=0.0034). CONCLUSIONS A patient's clinical history can help determine whether ECD could provide added value for breast cancer management.
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Affiliation(s)
- Tao Wang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Jinmei Zhou
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Shaohua Zhang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Li Bian
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Haixu Hu
- Translational Medicine Center, Laboratory of Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Chunhong Xu
- Translational Medicine Center, Laboratory of Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Xiaopeng Hao
- Department of Breast Surgery, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Bing Liu
- Translational Medicine Center, Laboratory of Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Qinong Ye
- Department of Medical Molecular Biology, Institute of Beijing Biotechnology, Beijing, China
| | - Yi Liu
- Translational Medicine Center, Laboratory of Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.
| | - Zefei Jiang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
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