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Fabricio ASC, Michilin S, Zancan M, Agnolon V, Peloso L, Dittadi R, Scapinello A, Ceccarelli C, Gion M. Shed HER2 surrogacy evaluation in primary breast cancer patients: a study assessing tumor tissue HER2 expression at both extracellular and intracellular levels. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:260-267. [PMID: 30982358 DOI: 10.1080/00365513.2019.1600200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of the present study was to investigate serum HER2 extracellular domain (ECD) as a putative surrogate marker of the shedding phenomenon of HER2 receptor from the tumor tissue of primary breast cancer (BC) patients. A pilot retrospective study was conducted on 100 matched serum and tissue samples from patients with node-positive primary BC, stage II/III. Analysis of association and concordance between serum HER2 ECD levels (measured by chemiluminescence immunoassay) and the expression in matched tumor tissue of HER2 ECD and intracellular receptor domain (ICD) (determined by immunohistochemistry) were performed. The median serum HER2 ECD level was 9.4 ng/ml and cutoff values were set at 15.2 ng/ml or 13.0 ng/ml. HER2 ICD and ECD were overexpressed in tumor tissue of 19.8% and 6.9% of patients, respectively. Statistically significant associations were found between serum HER2 ECD levels and tissue expression of both HER2 ICD and ECD (p < .001; Fisher analysis). Moreover, strong concordances were found between serum HER2 ECD levels and tissue expression of HER2 ICD or ECD (cutoff 15.2 ng/ml: 80 and 92.5%, respectively). Our findings support a role for serum HER2 ECD as a surrogate marker of tissue HER2 status in primary BC, both for HER2 ICD or ECD expression.
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Affiliation(s)
- Aline S C Fabricio
- a Regional Center for Biomarkers, Department of Clinical Pathology and Transfusion Medicine , Azienda ULSS 3 Serenissima, Regional Hospital , Venice , Italy
| | - Silvia Michilin
- a Regional Center for Biomarkers, Department of Clinical Pathology and Transfusion Medicine , Azienda ULSS 3 Serenissima, Regional Hospital , Venice , Italy
| | - Matelda Zancan
- b Istituto Oncologico Veneto (IOV), IRCCS , Padua , Italy
| | - Valentina Agnolon
- a Regional Center for Biomarkers, Department of Clinical Pathology and Transfusion Medicine , Azienda ULSS 3 Serenissima, Regional Hospital , Venice , Italy
| | - Lucia Peloso
- a Regional Center for Biomarkers, Department of Clinical Pathology and Transfusion Medicine , Azienda ULSS 3 Serenissima, Regional Hospital , Venice , Italy
| | - Ruggero Dittadi
- c Laboratory Analysis Unit, Department of Clinical Pathology and Transfusion Medicine , Dell'Angelo Hospital, Azienda ULSS 3 Serenissima , Mestre-Venice , Italy
| | - Antonio Scapinello
- d Department of Pathology , General Regional Hospital, Azienda ULSS 2 Marca Trevigiana , Castelfranco Veneto , Italy
| | - Claudio Ceccarelli
- e Department of Specialized, Experimental, and Diagnostic Medicine - DIMES , University of Bologna, Policlinico S.Orsola-Malpighi , Bologna , Italy
| | - Massimo Gion
- a Regional Center for Biomarkers, Department of Clinical Pathology and Transfusion Medicine , Azienda ULSS 3 Serenissima, Regional Hospital , Venice , Italy
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High serum HER2 extracellular domain levels: correlation with a worse disease-free survival and overall survival in primary operable breast cancer patients. J Cancer Res Clin Oncol 2011; 138:275-84. [PMID: 22116318 DOI: 10.1007/s00432-011-1095-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 11/07/2011] [Indexed: 10/15/2022]
Abstract
PURPOSE High serum human epidermal growth factors receptor-2 (HER2) extracellular domain (ECD) has been identified as an independent prognostic indicator of poor prognosis in metastatic breast cancer. However, its prognostic value in primary operable breast cancer was still controversial. We aim to investigate the correlation between serum HER2 ECD levels and tissue HER2 status, the association between serum HER2 ECD levels and clinicopathological characteristics, and their impacts on disease-free survival (DFS) and overall survival (OS) in primary operable breast cancer. METHODS Two hundred and fifty-two primary operable breast cancer patients pretreated from 2002 to 2009 in Sun Yat-Sen University Cancer Center were enrolled in this study. Serum HER2 ECD was measured by chemiluminescent assay, and tissue HER2 status was accessed by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) assay. RESULTS There was a significant correlation between serum HER2 ECD levels and HER2 tissue status (P < 0.001, R = 0.36). High serum HER2 ECD levels (≥15 ng/mL) were significantly associated with age (≥35 years) (P = 0.028), postmenopausal status (P < 0.001), stage III (P < 0.001), tumor size (≥2 cm) (P < 0.001), lymph node involvement (P < 0.001), negative estrogen receptor (P = 0.005), and progesterone receptor status (P = 0.001). Multivariate analysis showed that high serum HER2 ECD level was an independent prognostic factor of worse DFS (P = 0.014) and OS (P = 0.014) in primary operable breast cancer patients. CONCLUSION Serum HER2 ECD level can reflect tissue HER2 status and can be an independent prognostic indicator for primary operable breast cancer patients.
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Leary AF, Hanna WM, van de Vijver MJ, Penault-Llorca F, Rüschoff J, Osamura RY, Bilous M, Dowsett M. Value and Limitations of Measuring HER-2 Extracellular Domain in the Serum of Breast Cancer Patients. J Clin Oncol 2009; 27:1694-705. [DOI: 10.1200/jco.2008.17.3989] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The human epidermal receptor-2 (HER-2) is overexpressed or amplified in 15% to 25% of breast cancers. Determination of HER-2 tumor status offers clinically useful information, as it selects patients who may benefit from treatment with trastuzumab, the monoclonal antibody against HER-2. Currently approved methods for HER-2 testing include immunohistochemistry or fluorescent in situ hybridization using tumor tissue. A fragment of HER-2 composed of its extracellular domain (ECD) can also be detected in the serum of some patients with breast cancer. As an easily accessible tumor marker, it could offer additional useful prognostic or predictive information. This review will briefly address the biology of the circulating HER-2 ECD and discuss the evidence to support the role, if any, for measuring HER-2 ECD levels in women with breast cancer. In particular, we focus on the value and limitations of serum ECD in both early and advanced breast cancer in the following clinical contexts: as a marker of HER-2 tumor tissue status; clinical implications of raised levels in women who have a tumor not overexpressing HER-2; as a prognostic indicator and as a predictor of response to treatment; and as a monitoring tool for early recurrence. On the basis of our review of the literature, we conclude that there is currently insufficient evidence to support the use of serum HER-2 ECD in the routine management of individual patients with breast cancer. This conclusion is in agreement with the 2007 American Society of Clinical Oncology guidelines on the use of biomarkers in breast cancer.
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Affiliation(s)
- Alexandra F. Leary
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Wedad M. Hanna
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Marc J. van de Vijver
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Frederique Penault-Llorca
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Josef Rüschoff
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert Y. Osamura
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Michael Bilous
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
| | - Mitch Dowsett
- From the Royal Marsden Hospital, London, United Kingdom; Sunnybrook and Women's College, Health Science Center, Toronto, Canada; Netherlands Cancer Institute, Amsterdam, the Netherlands; Centre Jean Perrin, Clermont-Ferrand, France; Klinikum Kassel, Kassel, Germany; Tokai University School of Medicine, Kanagawa, Japan; and Westmead Hospital, Westmead, New South Wales, Australia
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