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Hu Y, Jones D, Zhao W, Tozbikian G, Wesolowski R, Parwani AV, Li Z. Incidence, Clinicopathologic Features, HER2 Fluorescence In Situ Hybridization Profile, and Oncotype DX Results of Human Epidermal Growth Factor Receptor 2-Low Breast Cancers: Experience From a Single Academic Center. Mod Pathol 2023; 36:100164. [PMID: 36967073 DOI: 10.1016/j.modpat.2023.100164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 04/20/2023]
Abstract
Human epidermal growth factor receptor 2 (HER2)-low breast cancer, defined by an immunohistochemical (IHC) score of 1+ or 2+ with negative in situ hybridization, is emerging as a predictive marker for the use of the antibody-drug conjugate. To understand how this category differs from HER2-zero cases, we investigated clinicopathological characteristics and HER2 fluorescence in situ hybridization results in a large cohort of 1309 continuous HER2-negative invasive breast carcinomas from 2018 to 2021 evaluated by the Food and Drug Administration-approved HER2 IHC test. Additionally, we compared Oncotype DX recurrence scores and HER2 mRNA expression between HER-low and HER2-zero cases in a separate cohort of 438 estrogen receptor-positive (ER+) early-stage breast carcinoma cases from 2014 to 2016. Based on the cohort from 2018 to 2021, the incidence of HER2-low breast cancers was approximately 54%. HER2-low cases had less frequent grade 3 morphology, less frequent triple-negative results, ER and progesterone receptor negativity, and a higher mean HER2 copy number and HER2/CEP17 ratio than HER2-zero cases (P < .0001). Among ER+ cases, HER2-low cases showed significantly less frequent Nottingham grade 3 tumors. In the cohort from 2014 to 2016, HER2-low cases showed significantly higher ER+ percentages, fewer progesterone receptor-negative cases, lower Oncotype DX recurrence scores, and higher HER2 mRNA expression scores than HER2-zero cases. In summary, this is the first study, to our knowledge, using a large cohort of continuous cases evaluated by the Food and Drug Administration-approved HER2 IHC companion diagnostic test for HER2-low expression and HER2 fluorescence in situ hybridization profile in a real-world setting. Although HER2-low cases showed a higher HER2 copy number, ratio, and mRNA level than HER2-zero cases statistically, such small differences are unlikely to be biologically or clinically meaningful. However, our study suggests that HER2-low/ER+ early-stage breast carcinoma may represent a less aggressive group of breast carcinoma, given its association with a lower Nottingham grade and Oncotype DX recurrence score.
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Affiliation(s)
- Yan Hu
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Dan Jones
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Weiqiang Zhao
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Gary Tozbikian
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Robert Wesolowski
- Department of Internal Medicine, Medical Oncology Division, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Anil V Parwani
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Zaibo Li
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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2
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Zhang XN, Gao Y, Zhang XY, Guo NJ, Hou WQ, Wang SW, Zheng YC, Wang N, Liu HM, Wang B. Detailed curriculum vitae of HER2-targeted therapy. Pharmacol Ther 2023; 245:108417. [PMID: 37075933 DOI: 10.1016/j.pharmthera.2023.108417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
With the booming development of precision medicine, molecular targeted therapy has been widely used in clinical oncology treatment due to a smaller number of side effects and its superior accuracy compared to that of traditional strategies. Among them, human epidermal growth factor receptor 2 (HER2)-targeted therapy has attracted considerable attention and has been used in the clinical treatment of breast and gastric cancer. Despite excellent clinical effects, HER2-targeted therapy remains in its infancy due to its resulting inherent and acquired resistance. Here, a comprehensive overview of HER2 in numerous cancers is presented, including its biological role, involved signaling pathways, and the status of HER2-targeted therapy.
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Affiliation(s)
- Xiao-Nan Zhang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Ya Gao
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Xi-Ya Zhang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Ning-Jie Guo
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Wen-Qing Hou
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Shu-Wu Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Yi-Chao Zheng
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China
| | - Ning Wang
- The School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Hong-Min Liu
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China.
| | - Bo Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China; State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, Institute of Drug Discovery and Development, Zhengzhou University, Zhengzhou, China.
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3
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Dabbs DJ, Huang RS, Ross JS. Novel markers in breast pathology. Histopathology 2023; 82:119-139. [PMID: 36468266 DOI: 10.1111/his.14770] [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: 06/27/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 12/12/2022]
Abstract
Breast pathology is an ever-expanding database of information which includes markers, or biomarkers, that detect or help treat the disease as prognostic or predictive information. This review focuses on these aspects of biomarkers which are grounded in immunohistochemistry, liquid biopsies and next-generation sequencing.
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Affiliation(s)
- David J Dabbs
- PreludeDx, Laguna Hills, CA, USA.,Department of Pathology, University of Pittsburgh, Board Member, CASI (Consortium for Analytical Standardization in Immunohistochemistry), Pittsburgh, PA, USA
| | - Richard S Huang
- Clinical Development, Foundation Medicine, Cambridge, MA, USA
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4
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Lai HZ, Han JR, Fu X, Ren YF, Li ZH, You FM. Targeted Approaches to HER2-Low Breast Cancer: Current Practice and Future Directions. Cancers (Basel) 2022; 14:cancers14153774. [PMID: 35954438 PMCID: PMC9367369 DOI: 10.3390/cancers14153774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary HER2-low breast cancer (BC) accounts for more than half of breast cancer patients. Anti-HER2 therapy has been ineffective in HER2-low BC, for which palliative chemotherapy is the main treatment modality. The definitive efficacy of T-Dxd in HER2-low BC breaks previous treatment strategies, which will redefine HER2-low and thus reshape anti-HER2 therapy. This review summarizes detection technologies and novel agents for HER2-low BC, and explores their possible role in future clinics, to provide ideas for the diagnosis and treatment of HER2-low BC. Abstract HER2-low breast cancer (BC) has a poor prognosis, making the development of more suitable treatment an unmet clinical need. While chemotherapy is the main method of treatment for HER2-low BC, not all patients benefit from it. Antineoplastic therapy without chemotherapy has shown promise in clinical trials and is being explored further. As quantitative detection techniques become more advanced, they assist in better defining the expression level of HER2 and in guiding the development of targeted therapies, which include directly targeting HER2 receptors on the cell surface, targeting HER2-related intracellular signaling pathways and targeting the immune microenvironment. A new anti-HER2 antibody-drug conjugate called T-DM1 has been successfully tested and found to be highly effective in clinical trials. With this progress, it could eventually be transformed from a disease without a defined therapeutic target into a disease with a defined therapeutic molecular target. Furthermore, efforts are being made to compare the sequencing and combination of chemotherapy, endocrine therapy, and HER2-targeted therapy to improve prognosis to customize the subtype of HER2 low expression precision treatment regimens. In this review, we summarize the current and upcoming treatment strategies, to achieve accurate management of HER2-low BC.
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5
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Zhang H, Karakas C, Tyburski H, Turner BM, Peng Y, Wang X, Katerji H, Schiffhauer L, Hicks DG. HER2-low breast cancers: Current insights and future directions. Semin Diagn Pathol 2022; 39:305-312. [PMID: 35872032 DOI: 10.1053/j.semdp.2022.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/11/2022]
Abstract
In light of the significant clinical benefits of novel HER2-targeting antibody-drug conjugates in advanced HER2-low expressing breast cancers in recent phases I and III clinical trials, particularly trastuzumab-deruxtecan (T-Dxd), the new "HER2-low" category in breast cancers (breast cancer with a HER2 IHC score of 1+, or 2+ without gene amplification) has gained increasing attention. In the past year, "HER2-low" breast cancers have been under active investigation by both oncologists and pathologists. In this current review, we update the recent cutting-edge research on HER2-low breast cancers, with a focus on the biology of HER2-low breast cancers, the issues on the identification of HER2-low breast cancers by immunohistochemistry in current practice of pathology, and the future directions in this emerging category in breast cancers.
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Affiliation(s)
- Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States.
| | - Cansu Karakas
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States
| | - Haley Tyburski
- Class of 2024, University of Rochester, Rochester, NY, United States
| | - Bradley M Turner
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States
| | - Yan Peng
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Xi Wang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States
| | - Hani Katerji
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States
| | - Linda Schiffhauer
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States
| | - David G Hicks
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States
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6
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Zhang H, Katerji H, Turner BM, Hicks DG. HER2-Low Breast Cancers. Am J Clin Pathol 2022; 157:328-336. [PMID: 34519765 DOI: 10.1093/ajcp/aqab117] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/31/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Recent clinical trials have demonstrated significant clinical benefits from novel therapeutic compounds in breast cancer patient with human epidermal growth factor receptor 2 (HER2) immunohistochemical (IHC) score of 1+ or 2+ and negative in situ hybridization (ISH) result. A new concept of "HER2-low" breast cancer has been proposed and applied in the recent and ongoing clinical trials. In this article, we review the literature on the topic of HER2-low breast cancer. METHODS A literature search in PubMed was performed using key words related to HER2-low breast cancer. Major relevant studies that were presented in international breast cancer conferences were also included. RESULTS HER2-low breast cancer is currently defined as breast cancer with HER2 IHC score of 1+ or 2+ and negative ISH result. It likely represents a group of tumors with significant biological heterogeneity. Reports of clinical activity using the next generation of HER2-targeting antibody-drug conjugates in HER2-low breast cancers suggest that some strategies of targeting HER2 might be effective in this patient population while raising considerable concerns over limitations in our current testing methodologies and our ability to accurately identify such patients. CONCLUSIONS The promising efficacy of novel HER2-targeted therapy in advanced HER2-low breast cancers has raised the possibility for changing the clinical interpretation of HER2 status in breast cancer to include a HER2-low category; however, the definition of HER2-low breast cancer, the corresponding reliable and accurate quantitative HER2 testing methodology, and the biology of HER2-low breast cancer remain poorly defined.
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Affiliation(s)
- Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - Hani Katerji
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - Bradley M Turner
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - David G Hicks
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
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7
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Saura C, Matito J, Oliveira M, Wildiers H, Brufksy AM, Waters SH, Hurvitz SA, Moy B, Kim SB, Gradishar WJ, Queiroz GS, Cronemberger E, Wallweber GJ, Bebchuk J, Keyvanjah K, Lalani AS, Bryce R, Vivancos A, Eli LD, Delaloge S. Biomarker Analysis of the Phase III NALA Study of Neratinib + Capecitabine versus Lapatinib + Capecitabine in Patients with Previously Treated Metastatic Breast Cancer. Clin Cancer Res 2021; 27:5818-5827. [PMID: 34380637 PMCID: PMC9401509 DOI: 10.1158/1078-0432.ccr-21-1584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/09/2021] [Accepted: 08/06/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Neratinib plus capecitabine (N+C) demonstrated significant progression-free survival (PFS) benefit in NALA (NCT01808573), a randomized phase III trial comparing N+C with lapatinib + capecitabine (L+C) in 621 patients with HER2-positive (HER2+) metastatic breast cancer (MBC) who had received ≥2 prior HER2-directed regimens in the metastatic setting. We evaluated correlations between exploratory biomarkers and PFS. PATIENTS AND METHODS Somatic mutations were evaluated by next-generation sequencing on primary or metastatic samples. HER2 protein expression was evaluated by central IHC, H-score, and VeraTag/HERmark. p95 expression (truncated HER2) was measured by VeraTag. HRs were estimated using unstratified Cox proportional hazards models. RESULTS Four hundred and twenty samples had successful sequencing: 34.0% had PIK3CA mutations and 5.5% had HER2 (ERBB2) mutations. In the combined patient populations, PIK3CA mutations trended toward shorter PFS [wild-type vs. mutant, HR = 0.81; 95% confidence interval (CI), 0.64-1.03], whereas HER2 mutations trended toward longer PFS [HR = 1.69 (95% CI, 0.97-3.29)]. Higher HER2 protein expression was associated with longer PFS [IHC 3+ vs. 2+, HR = 0.67 (0.54-0.82); H-score ≥240 versus <240, HR = 0.77 (0.63-0.93); HERmark positive vs. negative, HR = 0.76 (0.59-0.98)]. Patients whose tumors had higher HER2 protein expression (any method) derived an increased benefit from N+C compared with L+C [IHC 3+, HR = 0.64 (0.51-0.81); H-score ≥ 240, HR = 0.54 (0.41-0.72); HERmark positive, HR = 0.65 (0.50-0.84)], as did patients with high p95 [p95 ≥2.8 relative fluorescence (RF)/mm2, HR = 0.66 (0.50-0.86) vs. p95 < 2.8 RF/mm2, HR = 0.91 (0.61-1.36)]. CONCLUSIONS PIK3CA mutations were associated with shorter PFS whereas higher HER2 expression was associated with longer PFS. Higher HER2 protein expression was also associated with a greater benefit for N+C compared with L+C.
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Affiliation(s)
- Cristina Saura
- Vall d'Hebron University Hospital, Barcelona, Spain.
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital Campus, Barcelona, Spain
- SOLTI Innovative Breast Cancer Research, Barcelona, Spain
| | - Judit Matito
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital Campus, Barcelona, Spain
| | - Mafalda Oliveira
- Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital Campus, Barcelona, Spain
- SOLTI Innovative Breast Cancer Research, Barcelona, Spain
| | | | | | | | - Sara A Hurvitz
- University of California at Los Angeles, Los Angeles, California
| | - Beverly Moy
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (South)
| | - William J Gradishar
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
| | | | | | - Gerald J Wallweber
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | | | | | | | | | - Ana Vivancos
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital Campus, Barcelona, Spain
- SOLTI Innovative Breast Cancer Research, Barcelona, Spain
| | - Lisa D Eli
- Puma Biotechnology Inc., Los Angeles, California
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8
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Abraham J, Montero AJ, Jankowitz RC, Salkeni MA, Beumer JH, Kiesel BF, Piette F, Adamson LM, Nagy RJ, Lanman RB, Sperinde J, Huang W, Allegra CJ, Srinivasan A, Wang Y, Pogue-Geile KL, Lucas PC, Jacobs SA. Safety and Efficacy of T-DM1 Plus Neratinib in Patients With Metastatic HER2-Positive Breast Cancer: NSABP Foundation Trial FB-10. J Clin Oncol 2019; 37:2601-2609. [PMID: 31442103 PMCID: PMC6784849 DOI: 10.1200/jco.19.00858] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Patients with human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer eventually develop resistance to dual-antibody therapy with trastuzumab plus pertuzumab. Mechanisms of resistance have not been well elucidated. We evaluated the safety, tolerability, and efficacy of ado-trastuzumab emtansine (T-DM1) plus neratinib in patients who progressed on trastuzumab plus pertuzumab. PATIENTS AND METHODS In this 3 + 3 dose-escalation study, patients with metastatic breast cancer who progressed on trastuzumab, pertuzumab, and a taxane were treated with T-DM1 at 3.6 mg/kg intravenously every 3 weeks and dose-escalating neratinib at 120, 160, 200, or 240 mg/d orally. RESULTS Twenty-seven patients were treated across four dose-levels of neratinib. Dose-limiting toxicity in cycle 1 was grade 3 diarrhea in six patients and grade 3 nausea in one; no patient experienced grade 4 diarrhea, and there were no grade 5 toxicities. Other grade 3 to 4 toxicities included nausea (11%), dehydration (11%), electrolyte abnormality (19%), thrombocytopenia (15%), elevated transaminase levels (7%), and fatigue (7%). Twelve (63%) of 19 evaluable patients had an objective response. Responses occurred at all neratinib doses. Plasma cell–free DNA at baseline showed ERBB2 (HER2) amplification in 10 of 27 patients. Deep and more durable responses occurred in patients with cell-free DNA ERBB2 amplification. Two complete responders had high expression of total HER2 and p95HER2 in baseline tissue. CONCLUSION We report the recommended phase II dose of T-DM1 3.6 mg/kg and neratinib 160 mg/d for this combination. Possible resistance mechanisms to HER2 antibodies may be loss of the HER2 receptor and high expression of p95HER2. These data provide the basis for an ongoing phase II study to better define the activity of this regimen.
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Affiliation(s)
- Jame Abraham
- NSABP Foundation, Pittsburgh, PA.,Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH
| | - Albert J Montero
- NSABP Foundation, Pittsburgh, PA.,Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH
| | - Rachel C Jankowitz
- NSABP Foundation, Pittsburgh, PA.,University of Pittsburgh School of Medicine, Pittsburgh, PA.,UPMC Hillman Cancer Center, Pittsburgh, PA
| | | | - Jan H Beumer
- NSABP Foundation, Pittsburgh, PA.,UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Brian F Kiesel
- NSABP Foundation, Pittsburgh, PA.,UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Fanny Piette
- International Drug Development Institute, Louvain-la-Neuve, Belgium
| | | | | | | | - Jeff Sperinde
- Monogram Biosciences, Laboratory Corporation of America Holdings, South San Francisco, CA
| | - Weidong Huang
- Monogram Biosciences, Laboratory Corporation of America Holdings, South San Francisco, CA
| | - Carmen J Allegra
- NSABP Foundation, Pittsburgh, PA.,University of Florida Health, Gainesville, FL
| | | | | | | | - Peter C Lucas
- NSABP Foundation, Pittsburgh, PA.,University of Pittsburgh School of Medicine, Pittsburgh, PA
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9
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Amplified fluorescence imaging of HER2 dimerization on cancer cells by using a co-localization triggered DNA nanoassembly. Mikrochim Acta 2019; 186:439. [PMID: 31197538 DOI: 10.1007/s00604-019-3549-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 05/24/2019] [Indexed: 12/18/2022]
Abstract
Convenient and sensitive detection of human epidermal growth factor receptor 2 (HER2) dimerization is highly desirable for molecule subtyping and guiding personalized HER2 targeted therapy of breast cancer. A colocalization-triggered DNA nanoassembly (CtDNA) strategy was developed for amplified imaging of HER2 dimerization. It exploits (a) the advantage of the specificity of aptamer proximity hybridization, and (b) the high sensitivity of hairpin-free nonlinear HCR. The mechanism of step-by-step hairpin-free nonlinear HCR for DNA dendritic nanoassembly was studied by native polyacrylamide gel electrophoresis, atomic force microscopy and fluorometry. The results revealed a high specificity, sensitivity, and excellent controllability of the DNA dendritic nanoassembly. The method was used to identify HER2 homodimers and HER2/HER3 heterodimers in various breast cancer cell lines using fluorescence microscopy. It was then extended to image and quantitatively evaluate HER2 homodimers in clinical formalin-fixed paraffin-embedded breast cancer tissue specimens. This revealed its remarkable accuracy and practicality for clinical diagnostics. Graphical abstract Schematic presentation of amplified imaging of human epidermal growth factor receptor 2 (HER2) dimerization on cancer cell surfaces by using a co-localization triggered DNA nanoassembly (CtDNA).
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10
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Hicks DG, Buscaglia B, Goda H, McMahon L, Natori T, Turner B, Soukiazian A, Okada H, Nakano Y. A novel detection methodology for HER2 protein quantitation in formalin-fixed, paraffin embedded clinical samples using fluorescent nanoparticles: an analytical and clinical validation study. BMC Cancer 2018; 18:1266. [PMID: 30563489 PMCID: PMC6299600 DOI: 10.1186/s12885-018-5172-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/03/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Clinical assays for the assessment of the human epidermal growth factor receptor-2 (HER2) status in breast cancer include immunohistochemistry (IHC) and in situ hybridization (ISH), both of which have limitations. Recent studies have suggested that a more quantitative approach to the measurement of HER2 protein expression may improve specificity in selecting patients for HER-2 targeted therapy. In the current study, we have used HER2 expression in breast cancer cell lines and clinical samples as a model to explore the potential utility of a novel immunodetection technique, using streptavidin coated Phosphor Integrated Dot fluorescent nanoparticles (PID), which can be quantitatively measured using computer analysis. METHODS The expression of HER2 protein in cell lines was evaluated with antibody-binding capacity using fluorescence-activated cell sorting (FACS) for comparison with PID measurements to test for correlations with existing quantitative protein analysis methodologies. Various other analytic validation tests were also performed, including accuracy, precision, sensitivity, robustness and reproducibility. A methods comparison study investigated correlations between PID versus IHC and ISH in clinical samples. Lastly, we measured HER2 protein expression using PID in the pretreatment biopsies from 34 HER2-positive carcinomas that had undergone neoadjuvant trastuzumab-based chemotherapy. RESULTS In the analytic validation, PID HER2 measurements showed a strong linear correlation with FACS analysis in breast cell lines, and demonstrated significant correlations with all aspects of precision, sensitivity, robustness and reproducibility. PID also showed strong correlations with conventional HER2 testing methodologies (IHC and ISH). In the neoadjuvant study, patients with a pathologic complete response (pCR) had a significantly higher PID score compared with patients who did not achieve a pCR (p = 0.011), and was significantly correlated to residual cancer burden (RCB) class (p = 0.026, R2 = 0.9975). CONCLUSIONS Analytic testing of PID showed that it may be a viable testing methodology that could offer advantages over other experimental or conventional biomarker diagnostic methodologies. Our data also suggests that PID quantitation of HER2 protein may offer an improvement over conventional HER2 testing in the selection of patients who will be the most likely to benefit from HER2-targeted therapy. Further studies with a larger cohort are warranted.
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Affiliation(s)
- David G Hicks
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Brandon Buscaglia
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Hideki Goda
- Konica Minolta INC., Bio Health Care Business Development Division, Corporate R&D Headquarters, No. 1 Sakura-machi, Hino-shi Tokyo, 191-8511, Japan
| | - Loralee McMahon
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Takako Natori
- Konica Minolta INC., Bio Health Care Business Development Division, Corporate R&D Headquarters, No. 1 Sakura-machi, Hino-shi Tokyo, 191-8511, Japan
| | - Bradley Turner
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Armen Soukiazian
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Hisatake Okada
- Konica Minolta INC., Bio Health Care Business Development Division, Corporate R&D Headquarters, No. 1 Sakura-machi, Hino-shi Tokyo, 191-8511, Japan
| | - Yasushi Nakano
- Konica Minolta INC., Bio Health Care Business Development Division, Corporate R&D Headquarters, No. 1 Sakura-machi, Hino-shi Tokyo, 191-8511, Japan
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11
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Sperinde J, Huang W, Vehtari A, Chenna A, Kellokumpu-Lehtinen PL, Winslow J, Bono P, Lie YS, Petropoulos CJ, Weidler J, Joensuu H. p95HER2 Methionine 611 Carboxy-Terminal Fragment Is Predictive of Trastuzumab Adjuvant Treatment Benefit in the FinHer Trial. Clin Cancer Res 2018. [PMID: 29535130 DOI: 10.1158/1078-0432.ccr-17-3250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: Expression of p95HER2 (p95), a truncated form of the HER2 receptor, which lacks the trastuzumab binding site but retains kinase activity, has been reported as a prognostic biomarker for poor outcomes in patients with trastuzumab-treated HER2-positive metastatic breast cancer. The impact of p95 expression on trastuzumab treatment efficacy in early HER2-positive breast cancer is less clear. In the current study, p95 was tested as a predictive marker of trastuzumab treatment benefit in the HER2-positive subset of the FinHer adjuvant phase III trial.Experimental Design: In the FinHer trial, 232 patients with HER2-positive early breast cancer were randomized to receive chemotherapy plus 9 weeks of trastuzumab or no trastuzumab treatment. Quantitative p95 protein expression was measured in formalin-fixed paraffin-embedded samples using the p95 VeraTag assay (Monogram Biosciences), specific for the M611 form of p95. Quantitative HER2 protein expression was measured using the HERmark assay (Monogram Biosciences). Distant disease-free survival (DDFS) was used as the primary outcome measure.Results: In the arm receiving chemotherapy only, increasing log10(p95) correlated with shorter DDFS (HR, 2.0; P = 0.02). In the arm receiving chemotherapy plus trastuzumab (N = 95), increasing log10(p95) was not correlated with a shorter DDFS. In a combined analysis of both treatment arms, high breast tumor p95 content was significantly correlated with trastuzumab treatment benefit in multivariate models (interaction P = 0.01).Conclusions: A high p95HER2/HER2 ratio identified patients with metastatic breast cancer with poor outcomes on trastuzumab-based therapies. Further investigation of the p95HER2/HER2 ratio as a potential prognostic or predictive biomarker for HER2-targeted therapy is warranted. Clin Cancer Res; 24(13); 3046-52. ©2018 AACR.
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Affiliation(s)
- Jeff Sperinde
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California.
| | - Weidong Huang
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Aki Vehtari
- Helsinki Institute for Information Technology HIIT, Department of Computer Science, Aalto University, Finland
| | - Ahmed Chenna
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | | | - John Winslow
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Petri Bono
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Yolanda S Lie
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Christos J Petropoulos
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Jodi Weidler
- Monogram Biosciences, currently Cepheid, Sunnyvale, California
| | - Heikki Joensuu
- Department of Oncology, Helsinki University Hospital & Helsinki University, Helsinki, Finland
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12
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Chumsri S, Sperinde J, Liu H, Gligorov J, Spano JP, Antoine M, Moreno Aspitia A, Tan W, Winslow J, Petropoulos CJ, Chenna A, Bates M, Weidler JM, Huang W, Dueck A, Perez EA. High p95HER2/HER2 Ratio Associated With Poor Outcome in Trastuzumab-Treated HER2-Positive Metastatic Breast Cancer NCCTG N0337 and NCCTG 98-32-52 (Alliance). Clin Cancer Res 2018. [PMID: 29530935 DOI: 10.1158/1078-0432.ccr-17-1864] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: p95HER2 is a truncated form of HER2 that confers resistance to trastuzumab in vitro, but clinical results have been conflicting to date. Given that p95HER2 levels correlate with total HER2 expression levels, which confer better outcomes, we sought to evaluate the p95HER2/HER2 ratio in the North Central Cancer Treatment Group N0337 and N98-32-52 trials.Experimental Design: The HERmark assay and VeraTag technology (Monogram Biosciences) were used to measure total HER2 and p95HER2 expression levels in 91 patient samples.Results: In the multivariate model, increasing total HER2 level was significantly associated with longer (OS; HR, 0.33; P = 0.002) and decreasing p95HER2 level was significantly associated with longer OS (HR, 4.2; P = 0.01). Total HER2 expression level was significantly associated with longer progression-free survival (PFS) (HR, 0.57; P = 0.04), whereas p95HER2 level was not (HR, 1.7; P = 0.25). However, there was a positive association between p95HER2 and total HER2 expression levels (R2 = 0.48; P < 0.001). Consistent with our hypothesis, the ratio of p95HER2/HER2 was significantly associated with worsening PFS (HR, 1.7; P = 0.04) and OS (HR, 2.8; P = 0.002). Patients with the highest tertile of p95HER2/HER2 values had significantly less favorable PFS (HR, 1.8; P = 0.06) and OS (HR, 2.3; P = 0.02).Conclusions: A high p95HER2/HER2 ratio identified patients with metastatic breast cancer with poor outcomes on trastuzumab-based therapies. Further investigation of the p95HER2/HER2 ratio as a potential prognostic or predictive biomarker for HER2-targeted therapy is warranted. Clin Cancer Res; 24(13); 3053-8. ©2018 AACR.
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Affiliation(s)
- Saranya Chumsri
- Center for Breast Health, Mayo Clinic, Jacksonville, Florida.
| | - Jeff Sperinde
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Heshan Liu
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | - Winston Tan
- Center for Breast Health, Mayo Clinic, Jacksonville, Florida
| | - John Winslow
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Christos J Petropoulos
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Ahmed Chenna
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | | | | | - Weidong Huang
- Monogram Biosciences, Inc., Laboratory Corporation of America Holdings, South San Francisco, California
| | - Amylou Dueck
- Alliance Statistics and Data Center, Mayo Clinic, Scottsdale, Arizona
| | - Edith A Perez
- Center for Breast Health, Mayo Clinic, Jacksonville, Florida
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13
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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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14
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Fichter CD, Przypadlo CM, Buck A, Herbener N, Riedel B, Schäfer L, Nakagawa H, Walch A, Reinheckel T, Werner M, Lassmann S. A new model system identifies epidermal growth factor receptor-human epidermal growth factor receptor 2 (HER2) and HER2-human epidermal growth factor receptor 3 heterodimers as potent inducers of oesophageal epithelial cell invasion. J Pathol 2017; 243:481-495. [PMID: 28940194 DOI: 10.1002/path.4987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 08/08/2017] [Accepted: 09/11/2017] [Indexed: 12/31/2022]
Abstract
Oesophageal squamous cell carcinomas and oesophageal adenocarcinomas show distinct patterns of ErbB expression and dimers. The functional effects of specific ErbB homodimers or heterodimers on oesophageal (cancer) cell behaviour, particularly invasion during early carcinogenesis, remain unknown. Here, a new cellular model system for controlled activation of epidermal growth factor receptor (EGFR) or human epidermal growth factor receptor 2 (HER2) and EGFR-HER2 or HER2-human epidermal growth factor receptor 3 (HER3) homodimers and heterodimers was studied in non-neoplastic squamous oesophageal epithelial Het-1A cells. EGFR, HER2 and HER3 intracellular domains (ICDs) were fused to dimerization domains (DmrA/DmrA and DmrC), and transduced into Het-1A cells lacking ErbB expression. Dimerization of EGFR, HER2 or EGFR-HER2 and HER2-HER3 ICDs was induced by synthetic ligands (A/A or A/C dimerizers). This was accompanied by phosphorylation of the respective EGFR, HER2 and HER3 ICDs and activation of distinct downstream signalling pathways, such as phospholipase Cγ1, Akt, STAT and Src family kinases. Phenotypically, ErbB dimers caused cell rounding and non-apoptotic blebbing, specifically in EGFR-HER2 and HER2-HER3 heterodimer cells. In a Transwell assay, cell migration velocity was elevated in HER2 dimer cells as compared with empty vector cells. In addition, HER2 dimer cells showed in increased cell invasion, reaching significance for induced HER2-HER3 heterodimers (P = 0.015). Importantly, in three-dimensional organotypic cultures, empty vector cells grew as a superficial cell layer, resembling oesophageal squamous epithelium. In contrast, induced HER2 homodimer cells were highly invasive into the matrix and formed cell clusters. This was associated with partial loss of cytokeratin 7 (when HER2 homodimers were modelled) and p63 (when EGFR-HER2 heterodimers were modelled), which suggests a change or loss of squamous cell differentiation. Controlled activation of specific EGFR, HER2 and HER3 homodimers and heterodimers caused oesophageal squamous epithelial cell migration and/or invasion, especially in a three-dimensional microenvironment, thereby functionally identifying ErbB homodimers and heterodimers as important drivers of oesophageal carcinogenesis. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Christiane Daniela Fichter
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Camilla Maria Przypadlo
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Achim Buck
- Research Unit Analytical Pathology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Nicola Herbener
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bianca Riedel
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luisa Schäfer
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hiroshi Nakagawa
- Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Axel Walch
- Research Unit Analytical Pathology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Thomas Reinheckel
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute of Molecular Medicine and Cell Research, University of Freiburg, Freiburg, Germany.,Comprehensive Cancer Centre Freiburg, Medical Centre, University of Freiburg, Freiburg, Germany.,BIOSS Centre for Biological Signalling Studies, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Martin Werner
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Comprehensive Cancer Centre Freiburg, Medical Centre, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Silke Lassmann
- Institute for Surgical Pathology, Medical Centre, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany.,Comprehensive Cancer Centre Freiburg, Medical Centre, University of Freiburg, Freiburg, Germany.,BIOSS Centre for Biological Signalling Studies, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Centre (DKFZ), Heidelberg, Germany
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15
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Nishimura R, Toh U, Tanaka M, Saimura M, Okumura Y, Saito T, Tanaka T, Teraoka M, Shimada K, Katayama K, Koga T, Kurashita K, Hasegawa S, Todoroki H, Kai Y, Ohi Y, Toyoshima S, Arima N, Mitsuyama S, Tamura K. Role of HER2-Related Biomarkers (HER2, p95HER2, HER3, PTEN, and PIK3CA) in the Efficacy of Lapatinib plus Capecitabine in HER2-Positive Advanced Breast Cancer Refractory to Trastuzumab. Oncology 2017; 93:51-61. [PMID: 28478451 DOI: 10.1159/000468521] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/28/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the correlation between human epidermal growth factor receptor 2 (HER2)-related biomarkers and the treatment outcomes using lapatinib plus capecitabine (LC) and to evaluate the influence of the estrogen receptor (ER) status in trastuzumab-refractory HER2-positive advanced breast cancer. METHOD Eighty patients were enrolled in this study. Total HER2, p95HER2, and total HER3 expression were quantified using the VeraTag assays. PTEN (phosphatase and tensin homolog) and p95 expression was evaluated using immunohistochemistry and PIK3CA mutation using direct sequencing. RESULTS The response rate to LC was 30%, clinical benefit rate was 51.3%, and the median progression-free survival (PFS) was 174.5 days. ER negativity significantly correlated with higher HER2 and p95HER2. The lower HER2 and PIK3CA mutations were often observed in the nonresponders. A high p95HER2 expression correlated with longer PFS especially in the high HER2- and ER-positive cases. Patients without the PIK3CA mutation showed longer PFS in the same subset. Overall survival after LC significantly correlated with the number of recurrence organs. CONCLUSION LC therapy is effective in trastuzumab-refractory HER2-positive breast cancer. Moreover, the biomarker expression differed depending on ER status, and a high p95HER2 expression and wild-type PIK3CA gene correlated with longer PFS especially in the ER-positive cases.
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Affiliation(s)
- Reiki Nishimura
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Japan
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16
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ErbB Family Signalling: A Paradigm for Oncogene Addiction and Personalized Oncology. Cancers (Basel) 2017; 9:cancers9040033. [PMID: 28417948 PMCID: PMC5406708 DOI: 10.3390/cancers9040033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 02/07/2023] Open
Abstract
ErbB family members represent important biomarkers and drug targets for modern precision therapy. They have gained considerable importance as paradigms for oncoprotein addiction and personalized medicine. This review summarizes the current understanding of ErbB proteins in cell signalling and cancer and describes the molecular rationale of prominent cases of ErbB oncoprotein addiction in different cancer types. In addition, we have highlighted experimental technologies for the development of innovative cancer cell models that accurately predicted clinical ErbB drug efficacies. In the future, such cancer models might facilitate the identification and validation of physiologically relevant novel forms of oncoprotein and non-oncoprotein addiction or synthetic lethality. The identification of genotype-drug response relationships will further advance personalized oncology and improve drug efficacy in the clinic. Finally, we review the most important drugs targeting ErbB family members that are under investigation in clinical trials or that made their way already into clinical routine. Taken together, the functional characterization of ErbB oncoproteins have significantly increased our knowledge on predictive biomarkers, oncoprotein addiction and patient stratification and treatment.
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17
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Malik PRV, Hamadeh A, Phipps C, Edginton AN. Population PBPK modelling of trastuzumab: a framework for quantifying and predicting inter-individual variability. J Pharmacokinet Pharmacodyn 2017; 44:277-290. [PMID: 28260166 DOI: 10.1007/s10928-017-9515-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/01/2017] [Indexed: 12/11/2022]
Abstract
In this work we proposed a population physiologically-based pharmacokinetic (popPBPK) framework for quantifying and predicting inter-individual pharmacokinetic variability using the anti-HER2 monoclonal antibody (mAb) trastuzumab as an example. First, a PBPK model was developed to account for the possible mechanistic sources of variability. Within the model, five key factors that contribute to variability were identified and the nature of their contribution was quantified with local and global sensitivity analyses. The five key factors were the concentration of membrane-bound HER2 ([Formula: see text]), the convective flow rate of mAb through vascular pores ([Formula: see text]), the endocytic transport rate of mAb through vascular endothelium ([Formula: see text]), the degradation rate of mAb-HER2 complexes ([Formula: see text]) and the concentration of shed HER2 extracellular domain in circulation ([Formula: see text]). [Formula: see text] was the most important parameter governing trastuzumab distribution into tissues and primarily affected variability in the first 500 h post-administration. [Formula: see text] was the most significant contributor to variability in clearance. These findings were used together with population generation methods to accurately predict the observed variability in four experimental trials with trastuzumab. To explore anthropometric sources of variability, virtual populations were created to represent participants in the four experimental trials. Using populations with only their expected anthropometric diversity resulted in under-prediction of the observed inter-individual variability. Adapting the populations to include literature-based variability around the five key parameters enabled accurate predictions of the variability in the four trials. The successful application of this framework demonstrates the utility of popPBPK methods to understand the mechanistic underpinnings of pharmacokinetic variability.
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Affiliation(s)
- Paul R V Malik
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, ON, N2G 1C5, Canada
| | - Abdullah Hamadeh
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, ON, N2G 1C5, Canada
| | - Colin Phipps
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, ON, N2G 1C5, Canada
| | - Andrea N Edginton
- School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, ON, N2G 1C5, Canada.
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18
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Jensen K, Krusenstjerna-Hafstrøm R, Lohse J, Petersen KH, Derand H. A novel quantitative immunohistochemistry method for precise protein measurements directly in formalin-fixed, paraffin-embedded specimens: analytical performance measuring HER2. Mod Pathol 2017; 30:180-193. [PMID: 27767098 DOI: 10.1038/modpathol.2016.176] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 12/16/2022]
Abstract
In clinical routine pathology today, detection of protein in intact formalin-fixed, paraffin-embedded tissue is limited to immunohistochemistry, which is semi-quantitative. This study presents a new and reliable quantitative immunohistochemistry method, qIHC, based on a novel amplification system that enables quantification of protein directly in formalin-fixed, paraffin-embedded tissue by counting of dots. The qIHC technology can be combined with standard immunohistochemistry, and assessed using standard bright-field microscopy or image analysis. The objective was to study analytical performance of the qIHC method. qIHC was tested under requirements for an analytical quantitative test, and compared with ELISA and flow cytometry for quantitative protein measurements. Human epidermal growth factor receptor 2 (HER2) protein expression was measured in five different cell lines with HER2 expression from undetectable with immunohistochemistry to strong positive staining (IHC 3+). Repeatability, reproducibility, robustness, linearity, dynamic range, sensitivity, and quantification limits were evaluated. Reproducibility and robustness were assessed in a setup to resemble daily work in a laboratory using a commercial immunohistochemistry platform. In addition, qIHC was correlated to standard HER2 immunohistochemistry in 44 breast cancer specimens. For all evaluated parameters, qIHC performance was either comparable or better than the reference methods. Furthermore, qIHC has a lower limit of detection than both immunohistochemistry and the ELISA reference method, and demonstrated ability to measure HER2 accurately and precise within a large dynamic range. In conclusion, the results show that qIHC provides a sensitive, quantitative, accurate, and robust assay for measurement of protein expression in formalin-fixed, paraffin-embedded cell lines, and tissue.
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Affiliation(s)
- Kristian Jensen
- Dako Denmark A/S, an Agilent Technologies Company, Produktionsvej 42, Glostrup, Denmark
| | | | - Jesper Lohse
- Dako Denmark A/S, an Agilent Technologies Company, Produktionsvej 42, Glostrup, Denmark
| | - Kenneth H Petersen
- Dako Denmark A/S, an Agilent Technologies Company, Produktionsvej 42, Glostrup, Denmark
| | - Helene Derand
- Dako Denmark A/S, an Agilent Technologies Company, Produktionsvej 42, Glostrup, Denmark
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19
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Li JY, Perry SR, Muniz-Medina V, Wang X, Wetzel LK, Rebelatto MC, Hinrichs MJM, Bezabeh BZ, Fleming RL, Dimasi N, Feng H, Toader D, Yuan AQ, Xu L, Lin J, Gao C, Wu H, Dixit R, Osbourn JK, Coats SR. A Biparatopic HER2-Targeting Antibody-Drug Conjugate Induces Tumor Regression in Primary Models Refractory to or Ineligible for HER2-Targeted Therapy. Cancer Cell 2016; 29:117-29. [PMID: 26766593 DOI: 10.1016/j.ccell.2015.12.008] [Citation(s) in RCA: 246] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/18/2015] [Accepted: 12/15/2015] [Indexed: 01/29/2023]
Abstract
Antibody-drug conjugate (ADC) which delivers cytotoxic drugs specifically into targeted cells through internalization and lysosomal trafficking has emerged as an effective cancer therapy. We show that a bivalent biparatopic antibody targeting two non-overlapping epitopes on HER2 can induce HER2 receptor clustering, which in turn promotes robust internalization, lysosomal trafficking, and degradation. When conjugated with a tubulysin-based microtubule inhibitor, the biparatopic ADC demonstrates superior anti-tumor activity over ado-trastuzumab emtansine (T-DM1) in tumor models representing various patient subpopulations, including T-DM1 eligible, T-DM1 ineligible, and T-DM1 relapsed/refractory. Our findings indicate that this biparatopic ADC has promising potential as an effective therapy for metastatic breast cancer and a broader patient population may benefit from this unique HER2-targeting ADC.
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Affiliation(s)
- John Y Li
- Biosuperiors, MedImmune LLC, Gaithersburg, MD 20878, USA.
| | - Samuel R Perry
- Biosuperiors, MedImmune LLC, Gaithersburg, MD 20878, USA
| | | | - Xinzhong Wang
- Biosuperiors, MedImmune LLC, Gaithersburg, MD 20878, USA
| | | | | | | | - Binyam Z Bezabeh
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Ryan L Fleming
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Nazzareno Dimasi
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Hui Feng
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Dorin Toader
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Andy Q Yuan
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Lan Xu
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Jia Lin
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Changshou Gao
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Herren Wu
- Antibody Discovery & Protein Engineering, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Rakesh Dixit
- Biologics Safety Assessment, MedImmune LLC, Gaithersburg, MD 20878, USA
| | - Jane K Osbourn
- Biosuperiors, MedImmune LLC, Gaithersburg, MD 20878, USA; MedImmune Ltd, Granta Park, Cambridge CB21 6GH, UK
| | - Steven R Coats
- Biosuperiors, MedImmune LLC, Gaithersburg, MD 20878, USA
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20
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Advani PP, Crozier JA, Perez EA. HER2 testing and its predictive utility in anti-HER2 breast cancer therapy. Biomark Med 2015; 9:35-49. [PMID: 25605454 DOI: 10.2217/bmm.14.95] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Breast cancer treatment is dependent on accurate pathologic diagnosis. HER2 testing is now universally recommended as part of evaluation of invasive breast cancer. HER2 testing is available via various slide and non-slide based assays, and interpretation of results continues to evolve. Herein we review these testing modalities and their incorporation into the 2013 ASCO/CAP guidelines. Once accurate HER2 status has been established the proper treatment based on recent clinical trials can be instituted.
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Affiliation(s)
- Pooja P Advani
- Division of Hematology & Oncology, Mayo Clinic, 4500 San Pablo Road S., Jacksonville, FL 32224, USA
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Pollock NI, Wang L, Wallweber G, Gooding WE, Huang W, Chenna A, Winslow J, Sen M, DeGrave KA, Li H, Zeng Y, Grandis JR. Increased Expression of HER2, HER3, and HER2:HER3 Heterodimers in HPV-Positive HNSCC Using a Novel Proximity-Based Assay: Implications for Targeted Therapies. Clin Cancer Res 2015; 21:4597-606. [PMID: 26138066 DOI: 10.1158/1078-0432.ccr-14-3338] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 06/13/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE In other cancer types, HPV infection has been reported to coincide with overexpression of HER2 (ERBB2) and HER3 (ERBB3); however, the association between HER2 or HER3 expression and dimer formation in HNSCC has not been reported. Overexpression of HER2 and HER3 may contribute to resistance to EGFR inhibitors, including cetuximab, although the contribution of HPV in modulating cetuximab response remains unknown. Determination of heterodimerization of HER receptors is challenging and has not been reported in HNSCC. The present study aimed to determine the expression of HER proteins in HPV(+) versus HPV(-) HNSCC tumors using a proximity-based protein expression assay (VeraTag), and to determine the efficacy of HER-targeting agents in HPV(+) and HPV(-) HNSCC cell lines. EXPERIMENTAL DESIGN Expression of total HER1, HER2, and HER3, p95HER2, p-HER3, HER1:HER1 homodimers, HER2:HER3 heterodimers, and the HER3-PI3K complex in 88 HNSCC was determined using VeraTag, including 33 baseline tumors from individuals treated in a trial including cetuximab. Inhibition of cell growth and protein activation with cetuximab and afatinib was compared in HPV(+) and HPV(-) cetuximab-resistant cell lines. RESULTS Expression of total HER2, total HER3, HER2:HER3 heterodimers, and the HER3:PI3K complex were significantly elevated in HPV(+) HNSCC. Total EGFR was significantly increased in HPV(-) HNSCC where VeraTag assay results correlated with IHC. Afatinib significantly inhibited cell growth when compared with cetuximab in the HPV(+) and HPV(-) cetuximab-resistant HNSCC cell lines. CONCLUSIONS These findings suggest that agents targeting multiple HER proteins may be effective in the setting of HPV(+) HNSCC and/or cetuximab resistance.
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Affiliation(s)
- Netanya I Pollock
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Lin Wang
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Gerald Wallweber
- Monogram Biosciences/Labcorp, Inc., South San Francisco, California
| | - William E Gooding
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Weidong Huang
- Monogram Biosciences/Labcorp, Inc., South San Francisco, California
| | - Ahmed Chenna
- Monogram Biosciences/Labcorp, Inc., South San Francisco, California
| | - John Winslow
- Monogram Biosciences/Labcorp, Inc., South San Francisco, California
| | - Malabika Sen
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kara A DeGrave
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Hua Li
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Yan Zeng
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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22
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Zacarias-Fluck MF, Morancho B, Vicario R, Luque Garcia A, Escorihuela M, Villanueva J, Rubio IT, Arribas J. Effect of cellular senescence on the growth of HER2-positive breast cancers. J Natl Cancer Inst 2015; 107:djv020. [PMID: 25972601 DOI: 10.1093/jnci/djv020] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/20/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Oncogene-induced senescence (OIS) is a tumor suppressor mechanism. However, senescent cells remain viable and display a distinct secretome (also known as senescence-associated secretory phenotype [SASP] or senescence messaging secretome, [SMS]) that, paradoxically, includes protumorigenic factors. OIS can be triggered by ectopic overexpression of HER2, a receptor tyrosine kinase and the driving oncogene in a subtype of human breast cancer. However, cellular senescence has not been characterized in HER2-positive tumors. METHODS Using an approach based on their inability to proliferate, we isolated naturally occurring senescent cells from a variety of tumor models including HER2-positive cells, transgenic mice (n = 3), and patient-derived xenografts (PDXs) (n = 6 mice per group from one PDX derived from one patient). Using different biochemical and cell biological techniques, we characterized the secretome of these senescent cells. All statistical tests were two-sided. RESULTS We found that senescent cells arise constantly in different models of advanced breast cancers overexpressing HER2 and constitute approximately 5% of tumor cells. In these models, IL-6 and other cytokines were expressed mainly, if not exclusively, by the naturally occurring senescent cells (95.1% and 45.0% of HCC1954 cells and cells from a HER2-positive PDX expressing a senescent marker expressed IL-6, respectively). Furthermore, inhibition of IL-6 impaired the growth of the HER2-positive PDX (mean tumor volume at day 101, control vs anti-huIL-6 treated, 332.2mm(3) [95% confidence interval {CI} = 216.6 to 449.8] vs 114.4mm(3) [95% CI = 12.79 to 216.0], P = .005). CONCLUSIONS Senescent cells can contribute to the growth of tumors by providing cytokines not expressed by proliferating cells, but required by these to thrive.
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Affiliation(s)
- Mariano F Zacarias-Fluck
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA).
| | - Beatriz Morancho
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
| | - Rocio Vicario
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
| | - Antonio Luque Garcia
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
| | - Marta Escorihuela
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
| | - Josep Villanueva
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
| | - Isabel T Rubio
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
| | - Joaquín Arribas
- Preclinical Research (MZF, BM, RV, ALG, ME, JV, JA) and Clinical Research Programs (ITR), Vall d'Hebron Institute of Oncology, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Campus de la UAB, Bellaterra, Spain (JA); Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain (JA)
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23
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Nuciforo P, Radosevic-Robin N, Ng T, Scaltriti M. Quantification of HER family receptors in breast cancer. Breast Cancer Res 2015; 17:53. [PMID: 25887735 PMCID: PMC4389676 DOI: 10.1186/s13058-015-0561-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The clinical success of trastuzumab in breast cancer taught us that appropriate tumor evaluation is mandatory for the correct identification of patients eligible for targeted therapies. Although HER2 protein expression by immunohistochemistry (IHC) and gene amplification by fluorescence in situ hybridization (FISH) assays are routinely used to select patients to receive trastuzumab, both assays only partially predict response to the drug. In the case of epidermal growth factor receptor (EGFR), the link between the presence of the receptor or its amplification and response to anti-EGFR therapies could not be demonstrated. Even less is known for HER3 and HER4, mainly due to lack of robust and validated assays detecting these proteins. It is becoming evident that, besides FISH and IHC, we need better assays to quantify HER receptors and categorize the patients for individualized treatments. Here, we present the current available methodologies to measure HER family receptors and discuss the clinical implications of target quantification.
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Affiliation(s)
- Paolo Nuciforo
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Passeig Vall d'Hebron 119-129, Barcelona, 08035, Spain.
- Universitat Autònoma de Barcelona, Barcelona, 08035, Spain.
| | - Nina Radosevic-Robin
- ERTICa Research Group, University of Auvergne EA4677, 63000, Clermont-Ferrand, France.
- Biopathology, Jean Perrin Comprehensive Cancer Center, 58 rue Montalembert, 63011, Clermont-Ferrand, France.
| | - Tony Ng
- Richard Dimbleby Department of Cancer Research, Randall Division of Cell and Molecular Biophysics and Division of Cancer Studies, King's College London, London, SE1 1UL, UK.
- UCL Cancer Institute, Paul O'Gorman Building, University College London, London, WC1E 6DD, UK.
- Breakthrough Breast Cancer Research Unit, Department of Research Oncology, Guy's Hospital King's College London School of Medicine, London, SE1 9RT, UK.
| | - Maurizio Scaltriti
- Human Oncology and Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 20, New York, NY, 10065, USA.
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24
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Yardley DA, Kaufman PA, Huang W, Krekow L, Savin M, Lawler WE, Zrada S, Starr A, Einhorn H, Schwartzberg LS, Adams JW, Lie Y, Paquet AC, Sperinde J, Haddad M, Anderson S, Brigino M, Pesano R, Bates MP, Weidler J, Bosserman L. Quantitative measurement of HER2 expression in breast cancers: comparison with 'real-world' routine HER2 testing in a multicenter Collaborative Biomarker Study and correlation with overall survival. Breast Cancer Res 2015; 17:41. [PMID: 25886996 PMCID: PMC4391602 DOI: 10.1186/s13058-015-0543-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/27/2015] [Indexed: 01/09/2023] Open
Abstract
Introduction Accurate assessment of HER2 status is critical in determining appropriate therapy for breast cancer patients but the best HER2 testing methodology has yet to be defined. In this study, we compared quantitative HER2 expression by the HERmark™ Breast Cancer Assay (HERmark) with routine HER2 testing by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), and correlated HER2 results with overall survival (OS) of breast cancer patients in a multicenter Collaborative Biomarker Study (CBS). Methods Two hundred and thirty-two formalin-fixed, paraffin-embedded breast cancer tissues and local laboratory HER2 testing results were provided by 11 CBS sites. HERmark assay and central laboratory HER2 IHC retesting were retrospectively performed in a blinded fashion. HER2 results by all testing methods were obtained in 192 cases. Results HERmark yielded a continuum of total HER2 expression (H2T) ranging from 0.3 to 403 RF/mm2 (approximately 3 logs). The distribution of H2T levels correlated significantly (P <0.0001) with all routine HER2 testing results. The concordance of positive and negative values (equivocal cases excluded) between HERmark and routine HER2 testing was 84% for local IHC, 96% for central IHC, 85% for local FISH, and 84% for local HER2 status. OS analysis revealed a significant correlation of shorter OS with HER2 positivity by local IHC (HR = 2.6, P = 0.016), central IHC (HR = 3.2, P = 0.015), and HERmark (HR = 5.1, P <0.0001) in this cohort of patients most of whom received no HER2-targeted therapy. The OS curve of discordant low (HER2 positive but H2T low, 10% of all cases) was aligned with concordant negative (HER2 negative and H2T low, HR = 1.9, P = 0.444), but showed a significantly longer OS than concordant positive (HER2 positive and H2T high, HR = 0.31, P = 0.024). Conversely, the OS curve of discordant high (HER2 negative but H2T high, 9% of all cases) was aligned with concordant positive (HR = 0.41, P = 0.105), but showed a significantly shorter OS than concordant negative (HR = 41, P <0.0001). Conclusions Quantitative HER2 measurement by HERmark is highly sensitive, accurately quantifies HER2 protein expression and correlates well with routine HER2 testing. When HERmark and local HER2 results were discordant, HERmark more accurately predicted overall survival.
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Affiliation(s)
- Denise A Yardley
- Sarah Cannon Research Institute, 3322 West End Avenue, Nashville, TN, 37203, USA. .,Tennessee Oncology, PLLC, 250 25th Avenue North, Nashville, TN, 37203, USA.
| | - Peter A Kaufman
- Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03766, USA.
| | - Weidong Huang
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Lea Krekow
- Texas Oncology Bedford, 1615 Hospital Parkway, Bedford, TX, 76022, USA.
| | - Michael Savin
- Texas Oncology and Medical City, 7777 Forest Lane, Dallas, TX, 75230, USA.
| | - William E Lawler
- St. Jude Heritage Medical Group, 2720 Harbor Boulevard, Fullerton, CA, 92835, USA.
| | - Stephen Zrada
- The Center for Cancer and Hematologic Disease, 1930 New Jersey 70 (East), Cherry Hill, NJ, 08003, USA.
| | - Alexander Starr
- Monroe Medical Associates, 71 Ald Taylor Way, Harvey, IL, 60426, USA.
| | - Harvey Einhorn
- Swedish American Regional Medical Center, 1401 East State Street, Rockford, IL, 61104, USA.
| | | | - John W Adams
- Arlington Cancer Center, 906 West Randol Mill Road, Arlington, TX, 76012, USA.
| | - Yolanda Lie
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Agnes C Paquet
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Institut de Pharmacologie Moléculaire et Cellulaire-IPMC, Sophia Antipolis, 660 Route des Lucioles, 06560, Valbonne, France.
| | - Jeff Sperinde
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Mojgan Haddad
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: HealthTell, 3130 Crow Canyon Place, San Ramon, CA, 94583, USA.
| | - Steve Anderson
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Marlon Brigino
- Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc, Research Triangle Park, NC, 27709, USA.
| | - Rick Pesano
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Quest Diagnostics, 33608 Ortega Highway, San Juan Capistrano, CA, 92675, USA.
| | - Michael P Bates
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Cepheid, 904 East Caribbean Drive, Sunnyvale, CA, 94089, USA.
| | - Jodi Weidler
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Cepheid, 904 East Caribbean Drive, Sunnyvale, CA, 94089, USA.
| | - Linda Bosserman
- Wilshire Oncology Medical Group, 8283 Grove Avenue, Rancho Cucamonga, CA, 91730, USA. .,Present address: City of Hope, 1500 East Duarte Road, Rancho Cucamonga, CA, 91010, USA.
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25
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Duchnowska R, Sperinde J, Chenna A, Huang W, Weidler JM, Winslow J, Haddad M, Paquet A, Lie Y, Trojanowski T, Mandat T, Kowalczyk A, Czartoryska-Arłukowicz B, Radecka B, Jarosz B, Staszkiewicz R, Kalinka-Warzocha E, Chudzik M, Biernat W, Jassem J. Quantitative HER2 and p95HER2 levels in primary breast cancers and matched brain metastases. Neuro Oncol 2015; 17:1241-9. [PMID: 25681308 DOI: 10.1093/neuonc/nov012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/15/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Patients with advanced breast cancer positive for human epidermal growth factor receptor 2 (HER2) are at high risk for brain metastasis (BM). The prevalence and significance of expression of HER2 and its truncated form p95HER2 (p95) in BM is unknown. METHODS Seventy-five pairs of formalin-fixed paraffin-embedded samples from matched primary breast cancers (PBCs) and BM were assayed for quantitative p95 and HER2-total (H2T) protein expression using the p95 VeraTag and HERmark assays, respectively. RESULTS There was a net increase in p95 and H2T expression in BM relative to the matched PBC (median 1.5-fold, P = .0007 and 2.1-fold, P < .0001, respectively). Cases with H2T-positive tumors were more likely to have the largest (≥5-fold) increase in p95 (odds ratio = 6.3, P = .018). P95 positivity in PBC correlated with progression-free survival (hazard ratio [HR] = 2.2, P = .013), trended with shorter time to BM (HR = 1.8, P = .070), and correlated with overall survival (HR = 2.1, P = .042). P95 positivity in BM correlated with time to BM (HR = 2.0, P = .016) but did not correlate with overall survival from the time of BM diagnosis (HR = 1.2, P = .61). CONCLUSIONS This is the first study of quantitative p95 and HER2 expression in matched PBC and BM. BM of breast cancer shows significant increases in expression of both biomarkers compared with matched PBC. These data provide a rationale for future correlative studies on p95 and HER2 levels in BM.
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Affiliation(s)
- Renata Duchnowska
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Jeff Sperinde
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Ahmed Chenna
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Weidong Huang
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Jodi M Weidler
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - John Winslow
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Mojgan Haddad
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Agnes Paquet
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Yolanda Lie
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Tomasz Trojanowski
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Tomasz Mandat
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Anna Kowalczyk
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Bogumiła Czartoryska-Arłukowicz
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Barbara Radecka
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Bożena Jarosz
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Rafal Staszkiewicz
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Ewa Kalinka-Warzocha
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Małgorzata Chudzik
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Wojciech Biernat
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Jacek Jassem
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
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Scaltriti M, Nuciforo P, Bradbury I, Sperinde J, Agbor-Tarh D, Campbell C, Chenna A, Winslow J, Serra V, Parra JL, Prudkin L, Jimenez J, Aura C, Harbeck N, Pusztai L, Ellis C, Eidtmann H, Arribas J, Cortes J, de Azambuja E, Piccart M, Baselga J. High HER2 expression correlates with response to the combination of lapatinib and trastuzumab. Clin Cancer Res 2015; 21:569-76. [PMID: 25467182 DOI: 10.1158/1078-0432.ccr-14-1824] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Expression of p95HER2 has been associated with resistance to trastuzumab-based therapy in patients with metastatic breast cancer. Conversely, high levels of HER2 have been linked with increased clinical benefit from anti-HER2 therapy. In this work, we aimed to investigate whether the levels of p95HER2 and HER2 can predict response to anti-HER2 therapy in patients with breast cancer. EXPERIMENTAL DESIGN We measured p95HER2 and HER2 by VeraTag and HERmark, respectively, in primary tumors of patients enrolled in the neoadjuvant phase III study NeoALTTO and correlated these variables with pathologic complete response (pCR) and progression-free survival (PFS) following lapatinib (L), trastuzumab (T), or the combination of both agents (L+T). RESULTS A positive correlation between p95HER2 and HER2 levels was found in the 274 cases (60%) in which quantification of both markers was possible. High levels of these markers were predictive for pCR, especially in the hormone receptor (HR)-positive subset of patients. High HER2 expression was associated with increased pCR rate upon L+T irrespective of the HR status. To examine whether the levels of either p95HER2 or HER2 could predict for PFS in patients treated with lapatinib, trastuzumab or L+T, we fit to the PFS data in Cox models containing log2(p95HER2) or log2(HER2). Both variables correlated with longer PFS. CONCLUSIONS Increasing HER2 protein expression correlated with increased benefit of adding lapatinib to trastuzumab. HER2 expression is a stronger predictor of pCR and PFS than p95HER2 for response to lapatinib, trastuzumab and, more significantly, L+T.
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Affiliation(s)
- Maurizio Scaltriti
- Human Oncology and Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Paolo Nuciforo
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Ian Bradbury
- Frontier Science (Scotland) Ltd., Inverness-shire, Scotland
| | - Jeff Sperinde
- Clinical Research, Monogram Biosciences, Inc., South San Francisco, California
| | | | | | - Ahmed Chenna
- Clinical Research, Monogram Biosciences, Inc., South San Francisco, California
| | - John Winslow
- Clinical Research, Monogram Biosciences, Inc., South San Francisco, California
| | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Josep Lluis Parra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Ludmila Prudkin
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - José Jimenez
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Claudia Aura
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology, and CCC LMU, University of Munich, Munich, Germany
| | - Lajos Pusztai
- Genetics and Genomics Program, Yale School of Medicine, New Haven, Connecticut
| | | | - Holger Eidtmann
- Department of Gynecology and Midwifery, University Hospital Kiel, Kiel, Germany
| | - Joaquin Arribas
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain. Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Javier Cortes
- Medical Oncology Department, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | - José Baselga
- Human Oncology and Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, New York, New York. Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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27
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Growdon WB, Groeneweg J, Byron V, DiGloria C, Borger DR, Tambouret R, Foster R, Chenna A, Sperinde J, Winslow J, Rueda BR. HER2 over-expressing high grade endometrial cancer expresses high levels of p95HER2 variant. Gynecol Oncol 2015; 137:160-6. [PMID: 25602714 DOI: 10.1016/j.ygyno.2015.01.533] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 01/08/2015] [Accepted: 01/13/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Subsets of high grade endometrial cancer (EnCa) over-express HER2 (ERBB2), yet clinical trials have failed to demonstrate any anti-tumor activity utilizing trastuzumab, an approved platform for HER2 positive breast cancer (BrCa). A truncated p95HER2 variant lacking the trastuzumab binding site may confer resistance. The objective of this investigation was to characterize the expression of the p95HER2 truncated variant in EnCa. MATERIALS AND METHODS With institutional approval, 86 high grade EnCa tumors were identified with tumor specimens from surgeries performed between 2000 and 2011. Clinical data were collected and all specimens underwent tumor genotyping, HER2 immunohistochemistry (IHC, HercepTest®), HER2 fluorescent in situ hybridization (FISH), along with total HER2 (H2T) and p95HER2 assessment with VeraTag® testing. Regression models were used to compare a cohort of 86 breast tumors selected for equivalent HER2 protein expression. RESULTS We identified 44 high grade endometrioid and 42 uterine serous carcinomas (USC). IHC identified high HER2 expression (2+ or 3+) in 59% of the tumors. HER2 gene amplification was observed in 16 tumors (12 USC, 4 endometrioid). Both HER2 gene amplification and protein expression correlated with H2T values. High p95HER2 expression above 2.8RF/mm2 was observed in 53% (n=54) with significant correlation with H2T levels. When matched to a cohort of 107 breast tumors based on HercepTest HER2 expression, high grade EnCa presented with higher p95 levels (p<0.001). CONCLUSIONS These data demonstrate that compared to BrCa, high grade EnCa expresses higher levels of p95HER2 possibly providing rationale for the trastuzumab resistance observed in EnCa.
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Affiliation(s)
- Whitfield B Growdon
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States; Gynecologic Oncology Division, Vincent Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
| | - Jolijn Groeneweg
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Virginia Byron
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Celeste DiGloria
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Darrell R Borger
- Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA 02115, United States
| | - Rosemary Tambouret
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States
| | - Rosemary Foster
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States; Gynecologic Oncology Division, Vincent Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States
| | - Ahmed Chenna
- Monogram Biosciences, San Francisco, CA 94080, United States
| | - Jeff Sperinde
- Monogram Biosciences, San Francisco, CA 94080, United States
| | - John Winslow
- Monogram Biosciences, San Francisco, CA 94080, United States
| | - Bo R Rueda
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States; Gynecologic Oncology Division, Vincent Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States
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28
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Duchnowska R, Sperinde J, Chenna A, Haddad M, Paquet A, Lie Y, Weidler JM, Huang W, Winslow J, Jankowski T, Czartoryska-Arłukowicz B, Wysocki PJ, Foszczyńska-Kłoda M, Radecka B, Litwiniuk MM, Zok J, Wiśniewski M, Zuziak D, Biernat W, Jassem J. Quantitative measurements of tumoral p95HER2 protein expression in metastatic breast cancer patients treated with trastuzumab: independent validation of the p95HER2 clinical cutoff. Clin Cancer Res 2014; 20:2805-13. [PMID: 24668646 DOI: 10.1158/1078-0432.ccr-13-2782] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE P95HER2 (p95) is a truncated form of the HER2, which lacks the trastuzumab-binding site and contains a hyperactive kinase domain. Previously, an optimal clinical cutoff of p95 expression for progression-free survival (PFS) and overall survival (OS) was defined using a quantitative VeraTag assay (Monogram Biosciences) in a training set of trastuzumab-treated metastatic breast cancer (MBC) patients. EXPERIMENTAL DESIGN In the current study, the predictive value of the p95 VeraTag assay cutoff established in the training set was retrospectively validated for PFS and OS in an independent series of 240 trastuzumab-treated MBC patients from multiple institutions. RESULTS In the subset of 190 tumors assessed as HER2-total (H2T)-positive using the quantitative HERmark assay (Monogram Biosciences), p95 VeraTag values above the predefined cutoff correlated with shorter PFS (HR = 1.43; P = 0.039) and shorter OS (HR = 1.94; P = 0.0055) where both outcomes were stratified by hormone receptor status and tumor grade. High p95 expression correlated with shorter PFS (HR = 2.41; P = 0.0003) and OS (HR = 2.57; P = 0.0025) in the hormone receptor-positive subgroup of patients (N = 78), but not in the hormone receptor-negative group. In contrast with the quantitative p95 VeraTag measurements, p95 immunohistochemical expression using the same antibody was not significantly correlated with outcomes. CONCLUSIONS The consistency in the p95 VeraTag cutoff across different cohorts of patients with MBC treated with trastuzumab justifies additional studies using blinded analyses in larger series of patients.
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Affiliation(s)
- Renata Duchnowska
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jeff Sperinde
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Ahmed Chenna
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Mojgan Haddad
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Agnes Paquet
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Yolanda Lie
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jodi M Weidler
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Weidong Huang
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - John Winslow
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Tomasz Jankowski
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Bogumiła Czartoryska-Arłukowicz
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Piotr J Wysocki
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Małgorzata Foszczyńska-Kłoda
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Barbara Radecka
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Maria M Litwiniuk
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jolanta Zok
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Michał Wiśniewski
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Dorota Zuziak
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Wojciech Biernat
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jacek Jassem
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
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Montemurro F, Prat A, Rossi V, Valabrega G, Sperinde J, Peraldo-Neia C, Donadio M, Galván P, Sapino A, Aglietta M, Baselga J, Scaltriti M. Potential biomarkers of long-term benefit from single-agent trastuzumab or lapatinib in HER2-positive metastatic breast cancer. Mol Oncol 2014; 8:20-6. [PMID: 24075779 PMCID: PMC5528507 DOI: 10.1016/j.molonc.2013.08.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/27/2013] [Accepted: 08/29/2013] [Indexed: 01/06/2023] Open
Abstract
In 2009 a prospective, randomized Phase II trial (NCT00842998) was initiated to evaluate the activity of HER2-targeting agents without chemotherapy (CT) in HER2-positive metastatic breast cancer (MBC) patients. The primary tumors of the patients enrolled in this study offered a unique opportunity to identify biomarkers that could predict durable clinical benefit from CT-free anti-HER2 therapy. Patients with HER2-positive MBC were randomized to trastuzumab or lapatinib as first-line therapy. CT was added to anti-HER2 therapy in patients failing to achieve tumor regression at the 8-week evaluation and in those progressing at any time. Expression analysis of 105 selected genes was performed from formalin-fixed paraffin-embedded primary tumor samples. The research-based PAM50 intrinsic subtypes were also identified. Additionally, quantitative HER2 (H2T) and p95HER2 (p95) protein expression were evaluated by HERmark® and VeraTag® assay, respectively. Predictors of persistence on protocol (PP) were studied by Cox univariate and multivariate analysis. Nineteen patients were enrolled. Median overall survival was 43 months and median PP was 3.8 months (0.8-38.8+), with 4 patients (21.1%) persisting on single agent trastuzumab or lapatinib for longer than 12 mo (14.9-38.8 + mo). Seventeen patients were evaluable for PP. Gene expression analysis revealed that high expression of the 17q12-21 amplicon genes HER2 and GRB7, and the PAM50 HER2-enriched intrinsic profile, were significantly associated with longer PP. Conversely, high expression of luminal-related genes such as PGR, MDM2 or PIK3CA, or the PAM50 luminal intrinsic profile correlated with reduced PP. Moreover, increasing H2T/p95 ratio was found to be significantly associated with longer PP (HR 0.56 per 2-fold increase in H2T/p95, P = 0.0015). Our data suggest that patients belonging to the "HER2-enriched" subtype and/or having high H2T/p95 protein expression ratio are exquisitely sensitive to anti-HER2 agents. MBC patients with these tumors could be candidates for studies aimed at establishing chemotherapy-free regimens.
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Affiliation(s)
- Filippo Montemurro
- Unit of Investigative Clinical Oncology (INCO), Fondazione del Piemonte per l'Oncologia, Institute of Candiolo (IRCCs), Str. Provinciale 142, 10060 Candiolo, Italy; Division of Medical Oncology, Fondazione del Piemonte per l'Oncologia, Institute of Candiolo (IRCCs), Str. Provinciale 142, 10060 Candiolo, Italy
| | - Aleix Prat
- Translational Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Valentina Rossi
- Unit of Investigative Clinical Oncology (INCO), Fondazione del Piemonte per l'Oncologia, Institute of Candiolo (IRCCs), Str. Provinciale 142, 10060 Candiolo, Italy
| | - Giorgio Valabrega
- Division of Medical Oncology, Fondazione del Piemonte per l'Oncologia, Institute of Candiolo (IRCCs), Str. Provinciale 142, 10060 Candiolo, Italy
| | - Jeff Sperinde
- Clinical Research, Monogram Biosciences, Inc., 345 Oyster Point Blvd., South San Francisco, CA, USA
| | - Caterina Peraldo-Neia
- Laboratory of Cell Therapy, Fondazione del Piemonte per l'Oncologia, Institute of Candiolo (IRCCs), Candiolo, Italy
| | - Michela Donadio
- A.O. Città della Salute e della Scienza di Torino - sede Molinette, C.so Bramante 88/90, 10126 Torino, Italy
| | - Patricia Galván
- Translational Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Sapino
- Department of Biological Sciences and Human Oncology, Universita di Torino, Str. Provinciale 142, 10060 Candiolo, Italy
| | - Massimo Aglietta
- Division of Medical Oncology, Fondazione del Piemonte per l'Oncologia, Institute of Candiolo (IRCCs), Str. Provinciale 142, 10060 Candiolo, Italy
| | - José Baselga
- Human Oncology & Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 20, New York, NY 10065, USA
| | - Maurizio Scaltriti
- Human Oncology & Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 20, New York, NY 10065, USA.
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30
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Wolff AC, Hammond MEH, Hicks DG, Dowsett M, McShane LM, Allison KH, Allred DC, Bartlett JMS, Bilous M, Fitzgibbons P, Hanna W, Jenkins RB, Mangu PB, Paik S, Perez EA, Press MF, Spears PA, Vance GH, Viale G, Hayes DF. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. Arch Pathol Lab Med 2014; 138:241-56. [PMID: 24099077 PMCID: PMC4086638 DOI: 10.5858/arpa.2013-0953-sa] [Citation(s) in RCA: 802] [Impact Index Per Article: 80.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE To update the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline recommendations for human epidermal growth factor receptor 2 (HER2) testing in breast cancer to improve the accuracy of HER2 testing and its utility as a predictive marker in invasive breast cancer. METHODS ASCO/CAP convened an Update Committee that included coauthors of the 2007 guideline to conduct a systematic literature review and update recommendations for optimal HER2 testing. RESULTS The Update Committee identified criteria and areas requiring clarification to improve the accuracy of HER2 testing by immunohistochemistry (IHC) or in situ hybridization (ISH). The guideline was reviewed and approved by both organizations. RECOMMENDATIONS The Update Committee recommends that HER2 status (HER2 negative or positive) be determined in all patients with invasive (early stage or recurrence) breast cancer on the basis of one or more HER2 test results (negative, equivocal, or positive). Testing criteria define HER2-positive status when (on observing within an area of tumor that amounts to >10% of contiguous and homogeneous tumor cells) there is evidence of protein overexpression (IHC) or gene amplification (HER2 copy number or HER2/CEP17 ratio by ISH based on counting at least 20 cells within the area). If results are equivocal (revised criteria), reflex testing should be performed using an alternative assay (IHC or ISH). Repeat testing should be considered if results seem discordant with other histopathologic findings. Laboratories should demonstrate high concordance with a validated HER2 test on a sufficiently large and representative set of specimens. Testing must be performed in a laboratory accredited by CAP or another accrediting entity. The Update Committee urges providers and health systems to cooperate to ensure the highest quality testing.
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Affiliation(s)
- Antonio C Wolff
- Antonio C. Wolff, Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore; Lisa M. McShane, National Cancer Institute, Bethesda, MD; M. Elizabeth H. Hammond, University of Utah School of Medicine and Intermountain Healthcare, Salt Lake City, UT; David G. Hicks, University of Rochester Medical Center, Rochester, NY; Mitch Dowsett, Royal Marsden Hospital, London, United Kingdom; Kimberly H. Allison, Stanford University Medical Center, Stanford; Patrick Fitzgibbons, St Jude Medical Center, Fullerton; Michael F. Press, University of Southern California, Los Angeles, CA; Donald C. Allred, Washington University School of Medicine, St Louis, MO; John M.S. Bartlett, Ontario Institute for Cancer Research; Wedad Hanna, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Michael Bilous, University of Western Sydney and Healthscope Pathology, Sydney, New South Wales, Australia; Robert B. Jenkins, Mayo Clinic, Rochester, MN; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Soonmyung Paik, National Surgical Adjuvant Breast and Bowel Project, Pitsburgh, PA; Edith A. Perez, Mayo Clinic, Jacksonville, FL; Patricia A. Spears, North Carolina State University, Raleigh, NC; Gail H. Vance, Indiana University Medical Center, Indianapolis, IN; Giuseppe Viale, University of Milan, European Institute of Oncology, Milan, Italy; and Daniel F. Hayes, University of Michigan Comprehensive Cancer Care Center, Ann Arbor, MI
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31
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Wolff AC, Hammond MEH, Hicks DG, Dowsett M, McShane LM, Allison KH, Allred DC, Bartlett JMS, Bilous M, Fitzgibbons P, Hanna W, Jenkins RB, Mangu PB, Paik S, Perez EA, Press MF, Spears PA, Vance GH, Viale G, Hayes DF. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol 2013; 31:3997-4013. [PMID: 24101045 DOI: 10.1200/jco.2013.50.9984] [Citation(s) in RCA: 2862] [Impact Index Per Article: 260.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To update the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline recommendations for human epidermal growth factor receptor 2 (HER2) testing in breast cancer to improve the accuracy of HER2 testing and its utility as a predictive marker in invasive breast cancer. METHODS ASCO/CAP convened an Update Committee that included coauthors of the 2007 guideline to conduct a systematic literature review and update recommendations for optimal HER2 testing. RESULTS The Update Committee identified criteria and areas requiring clarification to improve the accuracy of HER2 testing by immunohistochemistry (IHC) or in situ hybridization (ISH). The guideline was reviewed and approved by both organizations. RECOMMENDATIONS The Update Committee recommends that HER2 status (HER2 negative or positive) be determined in all patients with invasive (early stage or recurrence) breast cancer on the basis of one or more HER2 test results (negative, equivocal, or positive). Testing criteria define HER2-positive status when (on observing within an area of tumor that amounts to > 10% of contiguous and homogeneous tumor cells) there is evidence of protein overexpression (IHC) or gene amplification (HER2 copy number or HER2/CEP17 ratio by ISH based on counting at least 20 cells within the area). If results are equivocal (revised criteria), reflex testing should be performed using an alternative assay (IHC or ISH). Repeat testing should be considered if results seem discordant with other histopathologic findings. Laboratories should demonstrate high concordance with a validated HER2 test on a sufficiently large and representative set of specimens. Testing must be performed in a laboratory accredited by CAP or another accrediting entity. The Update Committee urges providers and health systems to cooperate to ensure the highest quality testing. This guideline was developed through a collaboration between the American Society of Clinical Oncology and the College of American Pathologists and has been published jointly by invitation and consent in both Journal of Clinical Oncology and the Archives of Pathology & Laboratory Medicine.
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Affiliation(s)
- Antonio C Wolff
- Antonio C. Wolff, Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore; Lisa M. McShane, National Cancer Institute, Bethesda, MD; M. Elizabeth H. Hammond, University of Utah School of Medicine and Intermountain Healthcare, Salt Lake City, UT; David G. Hicks, University of Rochester Medical Center, Rochester, NY; Mitch Dowsett, Royal Marsden Hospital, London, United Kingdom; Kimberly H. Allison, Stanford University Medical Center, Stanford; Patrick Fitzgibbons, St Jude Medical Center, Fullerton; Michael F. Press, University of Southern California, Los Angeles, CA; Donald C. Allred, Washington University School of Medicine, St Louis, MO; John M.S. Bartlett, Ontario Institute for Cancer Research; Wedad Hanna, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Michael Bilous, University of Western Sydney and Healthscope Pathology, Sydney, New South Wales, Australia; Robert B. Jenkins, Mayo Clinic, Rochester, MN; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Soonmyung Paik, National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Edith A. Perez, Mayo Clinic, Jacksonville, FL; Patricia A. Spears, North Carolina State University, Raleigh, NC; Gail H. Vance, Indiana University Medical Center, Indianapolis, IN; Giuseppe Viale, University of Milan, European Institute of Oncology, Milan, Italy; and Daniel F. Hayes, University of Michigan Comprehensive Cancer Care Center, Ann Arbor, MI
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32
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Powers AD, Palecek SP. Protein analytical assays for diagnosing, monitoring, and choosing treatment for cancer patients. JOURNAL OF HEALTHCARE ENGINEERING 2012; 3:503-534. [PMID: 25147725 DOI: 10.1260/2040-2295.3.4.503] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cancer treatment is often hindered by inadequate methods for diagnosing the disease or insufficient predictive capacity regarding therapeutic efficacy. Targeted cancer treatments, including Bcr-Abl and EGFR kinase inhibitors, have increased survival for some cancer patients but are ineffective in other patients. In addition, many patients who initially respond to targeted inhibitor therapy develop resistance during the course of treatment. Molecular analysis of cancer cells has emerged as a means to tailor treatment to particular patients. While DNA analysis can provide important diagnostic information, protein analysis is particularly valuable because proteins are more direct mediators of normal and diseased cellular processes. In this review article, we discuss current and emerging protein assays for improving cancer treatment, including trends toward assay miniaturization and measurement of protein activity.
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Affiliation(s)
- Alicia D Powers
- Department of Chemical and Biological Engineering University of Wisconsin-Madison
| | - Sean P Palecek
- Department of Chemical and Biological Engineering University of Wisconsin-Madison
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33
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Han SW, Cha Y, Paquet A, Huang W, Weidler J, Lie Y, Sherwood T, Bates M, Haddad M, Park IH, Oh DY, Lee KS, Im SA, Bang YJ, Ro J, Kim TY. Correlation of HER2, p95HER2 and HER3 expression and treatment outcome of lapatinib plus capecitabine in her2-positive metastatic breast cancer. PLoS One 2012; 7:e39943. [PMID: 22848366 PMCID: PMC3407213 DOI: 10.1371/journal.pone.0039943] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 05/29/2012] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lapatinib plus capecitabine is an effective treatment option for trastuzumab-refractory HER2-positive metastatic breast cancer. We have investigated the correlation between quantitative measures of HER2, p95HER2, and HER3 and treatment outcomes using lapatinib and capecitabine. METHODS Total HER2 (H2T), p95HER2 (p95), and total HER3 (H3T) expression were quantified in formalin-fixed paraffin-embedded samples using the VeraTag assays. Patients received lapatinib and capecitabine treatment following trastuzumab failure according to the Lapatinib Expanded Access Program. The association between the protein expression levels and clinical outcomes was analyzed. RESULTS A total of 52 patients were evaluable. H2T level was significantly higher in responders (median 93.49 in partial response, 47.66 in stable disease, and 17.27 in progressive disease; p = 0.020). Longer time-to-progression (TTP) was observed in patients with high H2T [p = 0.018, median 5.2 months in high (>14.95) vs. 1.8 in low (<14.95)] and high H3T [p = 0.017, median 5.0 months in high (>0.605) vs. 2.2 in low (<0.605)]. Patients having both high H2T and high H3T had significantly longer TTP [adjusted hazard ratio (HR) 0.38 (95% CI 0.20-0.73), p = 0.004] and overall survival [adjusted HR 0.46 (95% CI 0.24-0.89), p = 0.020]. No significant association between p95 and response or survival was observed. CONCLUSIONS These data suggest a correlation between high HER2 and high HER3 expression and treatment outcome, while no significant difference was observed between clinical outcome and p95 expression level in this cohort of HER2-positive, trastuzumab-refractory metastatic breast cancer patients treated with lapatinib and capecitabine.
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Affiliation(s)
- Sae-Won Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yongjun Cha
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Agnes Paquet
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Weidong Huang
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Jodi Weidler
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Yolanda Lie
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Thomas Sherwood
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Michael Bates
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Mojgan Haddad
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - In Hae Park
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Do-Youn Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yung-Jue Bang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jungsil Ro
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
- * E-mail: (TYK); (JR)
| | - Tae-You Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Molecular Medicine & Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
- * E-mail: (TYK); (JR)
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34
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Larson JS, Goodman LJ, Tan Y, Defazio-Eli L, Paquet AC, Cook JW, Rivera A, Frankson K, Bose J, Chen L, Cheung J, Shi Y, Irwin S, Kiss LDB, Huang W, Utter S, Sherwood T, Bates M, Weidler J, Parry G, Winslow J, Petropoulos CJ, Whitcomb JM. Analytical Validation of a Highly Quantitative, Sensitive, Accurate, and Reproducible Assay (HERmark) for the Measurement of HER2 Total Protein and HER2 Homodimers in FFPE Breast Cancer Tumor Specimens. PATHOLOGY RESEARCH INTERNATIONAL 2010; 2010:814176. [PMID: 21151530 PMCID: PMC2990097 DOI: 10.4061/2010/814176] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 04/03/2010] [Accepted: 04/06/2010] [Indexed: 11/20/2022]
Abstract
We report here the results of the analytical validation of assays that measure HER2 total protein (H2T) and HER2 homodimer (H2D) expression in Formalin Fixed Paraffin Embedded (FFPE) breast cancer tumors as well as cell line controls. The assays are based on the VeraTag technology platform and are commercially available through a central CAP-accredited clinical reference laboratory. The accuracy of H2T measurements spans a broad dynamic range (2-3 logs) as evaluated by comparison with cross-validating technologies. The measurement of H2T expression demonstrates a sensitivity that is approximately 7–10 times greater than conventional immunohistochemistry (IHC) (HercepTest). The HERmark assay is a quantitative assay that sensitively and reproducibly measures continuous H2T and H2D protein expression levels and therefore may have the potential to stratify patients more accurately with respect to response to HER2-targeted therapies than current methods which rely on semiquantitative protein measurements (IHC) or on indirect assessments of gene amplification (FISH).
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Affiliation(s)
- Jeffrey S Larson
- Department of Clinical Laboratory Operations, Monogram Biosciences, Inc., South San Francisco, CA 94080, USA
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