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Antos A, Topolska-Woś A, Woś M, Mitura A, Sarzyńska P, Lipiński T, Kurylcio A, Ziółkowski P, Świtalska M, Tkaczuk-Włach J, Gamian A, Polkowski WP, Staniszewska M. The unique monoclonal antibodies and immunochemical assay for comprehensive determination of the cell-bound and soluble HER2 in different biological samples. Sci Rep 2024; 14:3978. [PMID: 38368450 PMCID: PMC10874376 DOI: 10.1038/s41598-024-54590-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/14/2024] [Indexed: 02/19/2024] Open
Abstract
The expression of the HER2 (human epidermal growth factor receptor 2) protein in cancer cells is a well-established cancer marker used for diagnostic and therapeutic purposes in modern treatment protocols, especially in breast cancer. The gold-standard immunohistochemical diagnostic methods with the specific anti-HER2 antibodies are utilized in the clinic to measure expression level of the membrane-bound receptor. However, a soluble extracellular domain (ECD) of HER2 is released to the extracellular matrix, thus the blood assays for HER2 measurements present an attractive way for HER2 level determination. There is a need for accurate and validated assays that can be used to correlate the concentration of the circulating HER2 protein with disease clinical manifestations. Here we describe two monoclonal antibodies binding HER2 with a unique sequence of the complementarity-determining regions that recognize HER2 ECD. Development and validation of the sandwich enzyme-linked immunosorbent assay (ELISA) for quantification of the soluble HER2 in a variety of biological samples is also presented. The assay provides HER2 quantitation within a concentrations range from 1.56 to 100 ng/ml with sensitivity at the level of 0.5 ng/ml that meets the expectations for measurements of HER2 in the blood and tumor tissue samples. The method presents satisfactory intra- and inter-assay precision and accuracy for immunochemical quantification of biomarkers in biological samples. The utility of the generated monoclonal anti-HER2 antibodies has been confirmed for use in the precise measurement of HER2 (both cell-bound and soluble) in several types of biological material, including serum, solid tumor tissue, and cell culture medium. Additionally, the developed immunochemical tools have a potential for HER2 detection, not only in a wide range of sample types but also independently of the sample storage/pre-processing, allowing for comprehensive HER2 analysis in tissue (IHC), cultured cells (immunofluorescence) and blood (ELISA).
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Affiliation(s)
- Aleksandra Antos
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | | | - Marcin Woś
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | - Agata Mitura
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | - Paulina Sarzyńska
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland
| | - Tomasz Lipiński
- Lukasiewicz Research Network - PORT Polish Center for Technology Development, Stabłowicka 147, 54-066, Wrocław, Poland
| | - Andrzej Kurylcio
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13, 20-080, Lublin, Poland
| | - Piotr Ziółkowski
- Department of Pathomorphology, Wrocław Medical University, Marcinkowskiego 1, 50-368, Wrocław, Poland
| | - Marta Świtalska
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Joanna Tkaczuk-Włach
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, Staszica 4/6, 20-081, Lublin, Poland
| | - Andrzej Gamian
- Laboratory of Medical Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Wojciech P Polkowski
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13, 20-080, Lublin, Poland
| | - Magdalena Staniszewska
- SDS Optic, EcoTech Complex, Block A, Głęboka 39, 20-612, Lublin, Poland.
- Faculty of Medicine, The John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708, Lublin, Poland.
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Mun B, Kim R, Jeong H, Kang B, Kim J, Son HY, Lim J, Rho HW, Lim EK, Haam S. An immuno-magnetophoresis-based microfluidic chip to isolate and detect HER2-Positive cancer-derived exosomes via multiple separation. Biosens Bioelectron 2023; 239:115592. [PMID: 37603987 DOI: 10.1016/j.bios.2023.115592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/31/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
Exosomes are useful for cancer diagnosis and monitoring. However, clinical samples contain impurities that complicate direct analyses of cancer-derived exosomes. Therefore, a microfluidic chip-based magnetically labeled exosome isolation system (MEIS-chip) was developed as a lab-on-a-chip platform for human epidermal growth factor receptor 2 (HER2)-positive cancer diagnosis and monitoring. Various magnetic nanoclusters (MNCs) were synthesized with different degrees of magnetization, and antibodies were introduced to capture HER2-overexpressing and common exosomes using immunoaffinity. MNC-bonded exosomes were separated into different exits according to their magnetization degrees. The MEIS-chip efficiently separated HER2-overexpressing exosomes from common exosomes that did not contain disease-related information. The simultaneous separation of HER2-and non-HER2-overexpressing exosomes provided a means of analyzing high-purity HER2-overexpressing exosomes while minimizing the contribution of non-target exosomes, reducing misdiagnosis risk. Notably, common exosomes served as a negative control for monitoring real-time changes in HER2 expression. These findings support the application of MEIS-chip for cancer diagnosis and treatment monitoring via effective exosome isolation.
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Affiliation(s)
- Byeonggeol Mun
- Department of Chemical and Biomolecular Engineering, College of Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ryunhyung Kim
- Department of Chemical and Biomolecular Engineering, College of Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hyein Jeong
- Department of Chemical and Biomolecular Engineering, College of Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Byunghoon Kang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea; Genetics and Aging Research Unit, McCance Center for Brain Health, Mass General Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 114 16th Street, Charlestown, MA, 02129, USA
| | - Jinyoung Kim
- Department of Chemical and Biomolecular Engineering, College of Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hye Young Son
- Department of Radiology College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jaewoo Lim
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea; Medical Device Development Center, Osong Medical innovation foundation, 123, Osongsaengmyeong-ro, Chungcheongbuk-do, 28160, Republic of Korea
| | - Hyun Wook Rho
- Department of Radiology College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Eun-Kyung Lim
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea; Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34113, Republic of Korea; School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
| | - Seungjoo Haam
- Department of Chemical and Biomolecular Engineering, College of Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Jayasinghe R, Jayarajah U, Seneviratne S. Circulating Biomarkers in the Management of Breast Cancer. Biomark Med 2022. [DOI: 10.2174/9789815040463122010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Circulating biomarkers have become a promising modality in the
management of many cancers. Similarly, in breast cancer, circulatory biomarkers are
useful, non-invasive methods in the diagnosis, prognostication, and evaluation of
response to treatment. Invasive surgical biopsies can be potentially replaced by “liquid
biopsy,” which involves analysing circulatory biomarkers that may reveal features of
primary and metastatic disease. Therefore, providing an insight into the cancer biology
can be utilised to monitor treatment response, treatment-induced adaptation and tumour
and disease progression through non-invasive means. The objective of this review is to
provide an overview of the current status of the circulating biomarkers highlighting
their promising impact on the management of patients with breast cancer.
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Affiliation(s)
- Ravindri Jayasinghe
- Faculty of Medicine, University of Colombo,Department of Surgery,Department of Surgery, Faculty of Medicine, University of Colombo, Colombo,Sri Lanka
| | - Umesh Jayarajah
- Faculty of Medicine, University of Colombo,Department of Surgery,Department of Surgery, Faculty of Medicine, University of Colombo, Colombo,Sri Lanka
| | - Sanjeewa Seneviratne
- Faculty of Medicine, University of Colombo,Department of Surgery,Department of Surgery, Faculty of Medicine, University of Colombo, Colombo,Sri Lanka
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Ahirwar R. Recent advances in nanomaterials-based electrochemical immunosensors and aptasensors for HER2 assessment in breast cancer. Mikrochim Acta 2021; 188:317. [PMID: 34476602 DOI: 10.1007/s00604-021-04963-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/14/2021] [Indexed: 12/17/2022]
Abstract
Human epidermal growth factor receptor 2 (HER2) is one of the key molecular targets in breast cancer pathogenesis. Overexpression and/or amplification of HER2 in approximately 15-20% of breast cancer patients is associated with high mortality and poor prognosis. Accumulating evidence shows that accurate and sensitive detection of HER2 improves the survival outcomes for HER2-positive breast cancer patients from targeted therapies. The current methods of clinical determination of HER2 expression levels are based on slide-based assays that rely on invasively collected primary tumours. Alternatively, ELISA-based detection of the shredded HER2 extracellular domain (HER2-ECD) of has been suggested as a surrogate method for monitoring disease progress and treatment response in breast cancer patients. In the past decade, biosensors have emerged as an alternative modality for the detection of circulating HER2-ECD in human serum samples. In particular, electrochemical biosensors based on nanomaterials and antibodies and aptamers have been increasingly developed as promising tools for rapid, sensitive, and cost-effective detection of HER2-ECD. These biosensors harness the high affinity and specificity of antibodies and aptamers, and unique conductive properties, biocompatibility, large surface area, and chemical stability of nanomaterials for selective and sensitive assessment of the HER2. This review provides an overview of the recent advances in the application of nanomaterials-based immunosensors and aptasensors for detection of circulating HER2-ECD. In particular, various electrochemical techniques, detection approaches, and nanomaterials are discussed. Further, analytical figures of merit of various HER2 immunosensors and aptasensors are compared. Finally, possible challenges and potential opportunities for biosensor-based detection of HER2-ECD are discussed.
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Affiliation(s)
- Rajesh Ahirwar
- Department of Environmental Biochemistry, ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhauri, Bhopal, Madhya Pradesh, 462030, India.
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Shamshirian A, Aref AR, Yip GW, Ebrahimi Warkiani M, Heydari K, Razavi Bazaz S, Hamzehgardeshi Z, Shamshirian D, Moosazadeh M, Alizadeh-Navaei R. Diagnostic value of serum HER2 levels in breast cancer: a systematic review and meta-analysis. BMC Cancer 2020; 20:1049. [PMID: 33129287 PMCID: PMC7603697 DOI: 10.1186/s12885-020-07545-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Measurement of serum human epidermal growth factor receptor-2 (HER-2/neu) levels might play an essential role as a diagnostic/screening marker for the early selection of therapeutic approaches and predict prognosis in breast cancer patients. We aimed to undertake a systematic review and meta-analysis focusing on the diagnostic/screening value of serum HER-2 levels in comparison to routine methods. METHODS We performed a systematic search via PubMed, Scopus, Cochrane-Library, and Web of Science databases for human diagnostic studies reporting the levels of serum HER-2 in breast cancer patients, which was confirmed using the histopathological examination. Meta-analyses were carried out for sensitivity, specificity, accuracy, area under the ROC curve (AUC), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). RESULTS Fourteen studies entered into this investigation. The meta-analysis indicated the low sensitivity for serum HER2 levels (Sensitivity: 53.05, 95%CI 40.82-65.28), but reasonable specificity of 79.27 (95%CI 73.02-85.51), accuracy of 72.06 (95%CI 67.04-77.08) and AUC of 0.79 (95%CI 0.66-0.92). We also found a significant differences for PPV (PPV: 56.18, 95%CI 44.16-68.20), NPV (NPV: 76.93, 95%CI 69.56-84.31), PLR (PLR: 2.10, 95%CI 1.69-2.50) and NLR (NLR: 0.58, 95%CI 0.44-0.71). CONCLUSION Our findings revealed that although serum HER-2 levels showed low se nsitivity for breast cancer diagnosis, its specificity, accuracy and AUC were reasonable. Hence, it seems that the measurement of serum HER-2 levels can play a significant role as a verification test for initial negative screening test results, especially in low-income regions due to its cost-effectiveness and ease of implementation.
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Affiliation(s)
- Amir Shamshirian
- Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Science, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Reza Aref
- Belfer Center for Applied Cancer Science, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02215, USA.
| | - George W Yip
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117594, Singapore
| | - Majid Ebrahimi Warkiani
- School of Biomedical Engineering, University of Technology Sydney, Sydney, Ultimo, NSW, 2007, Australia
- Institute of Molecular Medicine, Sechenov First Moscow State University, Moscow, 119991, Russia
| | - Keyvan Heydari
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sajad Razavi Bazaz
- School of Biomedical Engineering, University of Technology Sydney, Sydney, Ultimo, NSW, 2007, Australia
| | - Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Danial Shamshirian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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ELISA assay employing epitope-specific monoclonal antibodies to quantify circulating HER2 with potential application in monitoring cancer patients undergoing therapy with trastuzumab. Sci Rep 2020; 10:3016. [PMID: 32080226 PMCID: PMC7033231 DOI: 10.1038/s41598-020-59630-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/02/2020] [Indexed: 11/08/2022] Open
Abstract
Circulating HER2 extracellular domain (HER2 ECD) levels were proposed as a surrogate for HER2 tissue expression to monitor breast cancer patients for early relapse or responses to standard or HER2-targeted therapies, such as the monoclonal antibody (mAb) trastuzumab. Currently, available commercial ELISA assays for HER2 ECD rely on antibodies recognizing undisclosed or unknown epitopes. In this work, two ELISA assays employing MGR2 and MGR3 epitope-specific mAbs for HER2 ECD were developed and validated, showing good assay precision and linearity of the dose-response signal within the dynamic range of 0.19-12.50 ng mL-1 and detection limits of 0.76 and 0.75 ng mL-1 for the MGR2 and MGR3 assays, respectively. The developed assay showed a good agreement with two widely used commercial kits for HER2 ECD quantification in serum samples from breast cancer patients. A complete characterization of mAb-HER2 ECD interaction was performed by means of surface plasmon resonance using trastuzumab as control for both epitope mapping and kinetics analysis. The epitopes recognized by the two mAbs showed no overlap with trastuzumab, which was confirmed by trastuzumab interference analysis in serum samples. The method showed to be a practical approach to determine HER2 ECD with a high degree of sensitivity, reliability and recovery in samples containing mAbs-based therapies.
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Pan J, Song Y, Xu B, Liu J, Fu L, Xu L. Preparation and application of immunoaffinity in-tube solid phase microextraction column with oriented antibody-immobilized porous layer open tubular capillary for high sensitive quantification of serum extracellular domain of human epidermal growth factor receptor 2 levels. J Chromatogr A 2020; 1619:460974. [PMID: 32087879 DOI: 10.1016/j.chroma.2020.460974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 11/20/2022]
Abstract
Human epidermal growth factor receptor 2 (HER2) gene expresses a transmembrane glycoprotein that is over-expressed in 15-30% breast, 3% lung, and other several digestive cancers. So HER2 is a good biomarker for tumor diagnostic and treatment monitoring. Clinically, detection of HER2 often employs invasive approaches with tissue samples, which at large extent limit its universal application. Shedding of the extracellular domain (ECD) of the HER2 (HER2-ECD) into the circulation has led to the development of a serum test of HER2-ECD as an additional approach to probe the HER2 overexpression. However, few methods were developed due to the high sensitivity required by the serum HER2-ECD determination. In this work, we prepared a novel immunoaffinity in-tube solid phase microextraction (IT-SPME) sorbent for selective enrichment of HER2-ECD. Two clinical available monoclonal antibodies against to HER2, trastuzumab and pertuzumab, were selected as immunoaffinity ligands. Porous layer open tubular capillary with oriented antibody immobilization were fabricated and systematically optimized to afford a higher extraction capacity. The capacity was reached to 120.4 μg/m, which is more than 1000 times higher than that obtained by a common method (directly antibody immobilization on a naked capillary). After sample extraction and enrichment by the IT-SPME, the eluent were determined by a particle-enhanced turbidimetric immunoassay (PETIA). Sensitive quantification of HER2-ECD by the PETIA was thereby accomplished. HER2-ECD concentrations in 82 clinical serum samples were determined by the developed IT-SPME/PETIA method, and the results were well-correlated with that by the clinical used chemiluminescence immunoassay (CLIA). Besides, the IT-SPME/PETIA method was found providing 5 times higher sensitivity than the CLIA, and 500 times higher than the PETIA without IT-SPME. The results indicate that the developed method is suitable for high-sensitive quantification of HER2-ECD in clinical samples.
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Affiliation(s)
- Jianhui Pan
- Graduate School, Tianjin Medical University, Tianjin, 300070, China; Tianjin Chest Hospital, Tianjin, 300222, China
| | - Yang Song
- Graduate School, Tianjin Medical University, Tianjin, 300070, China; School of Pharmacy, Tianjin Medical University, Tianjin, 300070, China; Sinopharm Group (Tianjin) East Bookcom Pharmaceutical Co., Ltd, Tianjin, 300051, China
| | - Bei Xu
- School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Jiyang Liu
- Tianjin Medical College, Tianjin, 300222, China
| | - Li Fu
- Department of Breast Cancer Pathology and Research Laboratory, State Key Laboratory of Breast Cancer Research, Cancer Hospital of Tianjin Medical University, Tianjin, 300060, China.
| | - Liang Xu
- School of Pharmacy, Tianjin Medical University, Tianjin, 300070, China; Tianjin Medical College, Tianjin, 300222, China; Department of Breast Cancer Pathology and Research Laboratory, State Key Laboratory of Breast Cancer Research, Cancer Hospital of Tianjin Medical University, Tianjin, 300060, China.
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Wang J, Xu B. Targeted therapeutic options and future perspectives for HER2-positive breast cancer. Signal Transduct Target Ther 2019; 4:34. [PMID: 31637013 PMCID: PMC6799843 DOI: 10.1038/s41392-019-0069-2] [Citation(s) in RCA: 200] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 12/12/2022] Open
Abstract
Over the past 2 decades, there has been an extraordinary progress in the regimens developed for the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Trastuzumab, pertuzumab, lapatinib, and ado-trastuzumab emtansine (T-DM1) are commonly recommended anti-HER2 target agents by the U.S. Food and Drug Administration. This review summarizes the most significant and updated research on clinical scenarios related to HER2-positive breast cancer management in order to revise the guidelines of everyday clinical practices. In this article, we present the data on anti-HER2 clinical research of neoadjuvant, adjuvant, and metastatic studies from the past 2 decades. We also highlight some of the promising strategies that should be critically considered. Lastly, this review lists some of the ongoing clinical trials, findings of which may soon be available.
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Affiliation(s)
- Jiani Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuannanli, Chaoyang District, 100021 Beijing, China
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuannanli, Chaoyang District, 100021 Beijing, China
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuannanli, Chaoyang District, 100021 Beijing, China
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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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Near-infrared MnCuInS/ZnS@BSA and urchin-like Au nanoparticle as a novel donor-acceptor pair for enhanced FRET biosensing. Anal Chim Acta 2018; 1042:71-78. [DOI: 10.1016/j.aca.2018.05.048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 04/20/2018] [Accepted: 05/18/2018] [Indexed: 12/13/2022]
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11
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Tao Q, Wu X, Lin Q, Zheng H, Yang W, Liu D, Yang CJ, Ji T. Portable detection of serum HER-2 in breast cancer by a pressure-based platform. Anal Bioanal Chem 2018; 410:7489-7498. [DOI: 10.1007/s00216-018-1364-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/24/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
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12
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Sims JD, Taguiam JM, Alonso-Valenteen F, Markman J, Agadjanian H, Chu D, Lubow J, Abrol R, Srinivas D, Jain A, Han B, Qu Y, Mirzadehgan P, Hwang JY, Rentsendorj A, Chung A, Lester J, Karlan BY, Gray HB, Gross Z, Giuliano A, Cui X, Medina-Kauwe LK. Resistance to receptor-blocking therapies primes tumors as targets for HER3-homing nanobiologics. J Control Release 2017; 271:127-138. [PMID: 29288681 PMCID: PMC5807213 DOI: 10.1016/j.jconrel.2017.12.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 12/09/2017] [Accepted: 12/21/2017] [Indexed: 01/28/2023]
Abstract
Resistance to anti-tumor therapeutics is an important clinical problem. Tumor-targeted therapies currently used in the clinic are derived from antibodies or small molecules that mitigate growth factor activity. These have improved therapeutic efficacy and safety compared to traditional treatment modalities but resistance arises in the majority of clinical cases. Targeting such resistance could improve tumor abatement and patient survival. A growing number of such tumors are characterized by prominent expression of the human epidermal growth factor receptor 3 (HER3) on the cell surface. This study presents a “Trojan-Horse” approach to combating these tumors by using a receptor-targeted biocarrier that exploits the HER3 cell surface protein as a portal to sneak therapeutics into tumor cells by mimicking an essential ligand. The biocarrier used here combines several functions within a single fusion protein for mediating targeted cell penetration and non-covalent self-assembly with therapeutic cargo, forming HER3-homing nanobiologics. Importantly, we demonstrate here that these nanobiologics are therapeutically effective in several scenarios of resistance to clinically approved targeted inhibitors of the human EGF receptor family. We also show that such inhibitors heighten efficacy of our nanobiologics on naïve tumors by augmenting HER3 expression. This approach takes advantage of a current clinical problem (i.e. resistance to growth factor inhibition) and uses it to make tumors more susceptible to HER3 nanobiologic treatment. Moreover, we demonstrate a novel approach in addressing drug resistance by taking inhibitors against which resistance arises and re-introducing these as adjuvants, sensitizing tumors to the HER3 nanobiologics described here.
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Affiliation(s)
| | | | | | | | | | - David Chu
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jay Lubow
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Anjali Jain
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bingchen Han
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ying Qu
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | | | - Alice Chung
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jenny Lester
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Harry B Gray
- California Institute of Technology, Pasadena, CA, USA
| | - Zeev Gross
- Technion-Israel Institute, Haifa, Israel
| | | | | | - Lali K Medina-Kauwe
- Cedars-Sinai Medical Center, Los Angeles, CA, USA; University of California, Los Angeles, CA, USA.
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13
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Kim YG, Yoon YN, Choi HS, Kim JH, Seol H, Lee JK, Seong MK, Park IC, Kim KI, Kim HA, Kim JS, Noh WC. Breast cancer stem cells in HER2-negative breast cancer cells contribute to HER2-mediated radioresistance and molecular subtype conversion: clinical implications for serum HER2 in recurrent HER2-negative breast cancer. Oncotarget 2017; 9:5811-5822. [PMID: 29464036 PMCID: PMC5814176 DOI: 10.18632/oncotarget.23528] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/04/2017] [Indexed: 01/03/2023] Open
Abstract
Although it has been proposed that the beneficial effect of HER2-targeted therapy in HER2-negative breast cancer is associated with the molecular subtype conversion, the underlying mechanism and the clinical biomarkers are unclear. Our study showed that breast cancer stem cells (BCSCs) mediated HER2 subtype conversion and radioresistance in HER2-negative breast cancer cells and evaluated serum HER2 as a clinical biomarker for HER2 subtype conversion. We found that the CD44+/CD24–/low BCSCs from HER2-negative breast cancer MCF7 cells overexpressed HER2 and EGFR and showed the radioresistant phenotype. In addition, we showed that trastuzumab treatment sensitized the radioresistant phenotype of the CD44+/CD24–/low cells with decreased levels of HER2 and EGFR, which suggested that HER2-targeted therapy in HER2-negative breast cancer could be useful for targeting BCSCs that overexpress HER2/EGFR. Importantly, our clinical data showed that serial serum HER2 measurement synchronously reflected the disease relapse and the change in tumor burden in some patients who were initially diagnosed as HER2-negative breast cancer, which indicated that serum HER2 could be a clinical biomarker for the evaluation of HER2 subtype conversion in patients with recurrent HER2-negative breast cancer. Therefore, our data have provided in vitro and in vivo evidence for the molecular subtype conversion of HER2-negative breast cancer.
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Affiliation(s)
- Yun Gyoung Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.,Department of Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Yi Na Yoon
- Division of Radiation Cancer Research, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.,Radiological and Medico-Oncological Sciences, University of Science and Technology, Seoul, Korea
| | - Hyang Suk Choi
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Ji-Hyun Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Hyesil Seol
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Jin Kyung Lee
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Min-Ki Seong
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - In Chul Park
- Division of Radiation Cancer Research, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Kwang Il Kim
- RI-Convergence Research, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Jae-Sung Kim
- Division of Radiation Cancer Research, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.,Radiological and Medico-Oncological Sciences, University of Science and Technology, Seoul, Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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14
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Aurilio G, Sandri MT, Pruneri G, Zorzino L, Botteri E, Munzone E, Adamoli L, Facchi G, Cullurà D, Verri E, Rocca MC, Zurrida S, Iacovelli R, Nolè F. Serum HER2 extracellular domain levels and HER2 circulating tumor cell status in patients with metastatic breast cancer. Future Oncol 2016; 12:2001-8. [DOI: 10.2217/fon-2016-0081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To shed light on the clinical role of HER2 status in serum as extracellular domain (ECD) and corresponding circulating tumor cells (CTCs) in metastatic breast cancer patients. Methods: 68 patients were analyzed. Serum HER2 was determined by ADVIA Centaur® Serum HER2 test. CellSearch System was performed for CTC quantification. Results: HER2 was overexpressed in 21 primary tumors. In total, 19 patients had ECD >15 ng/ml (the cut-off used), 48 patients had at least one CTC. ECD positivity was associated with CTC number (p = 0.01), HER2-positive CTC (p = 0.01) and the ratio HER2-positive CTC/total CTC (p = 0.02). ECD was not associated with survival. Conclusion: ECD in combination with HER2 CTC status would deserve further investigation in larger series for addressing its putative prognostic relevance.
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Affiliation(s)
- Gaetano Aurilio
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Maria Teresa Sandri
- European Institute of Oncology, Laboratory of Medicine, via Ripamonti 435, Milan, Italy
| | - Giancarlo Pruneri
- European Institute of Oncology, Division of Pathology & Laboratory Medicine, via Ripamonti 435, Milan, Italy & School of Medicine, University of Milan, Italy
| | - Laura Zorzino
- European Institute of Oncology, Laboratory of Medicine, via Ripamonti 435, Milan, Italy
| | - Edoardo Botteri
- European Institute of Oncology, Division of Epidemiology & Biostatistics, via Ripamonti 435, Milan
| | - Elisabetta Munzone
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Laura Adamoli
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Giuseppina Facchi
- European Institute of Oncology, Laboratory of Medicine, via Ripamonti 435, Milan, Italy
| | - Daniela Cullurà
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Elena Verri
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Maria Cossu Rocca
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Stefano Zurrida
- European Institute of Oncology, Division of Senology, via Ripamonti 435, Milan, Italy
| | - Roberto Iacovelli
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
| | - Franco Nolè
- European Institute of Oncology, Medical Oncology, via Ripamonti 435, Milan, Italy
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15
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Saito M, Kawakami Y, Yamashita K, Nasuno H, Ishimine YU, Fukuda K, Isshiki H, Suzuki R, Arimura Y, Shinomura Y. HER2-positive gastric cancer identified by serum HER2: A case report. Oncol Lett 2016; 11:3575-3578. [PMID: 27284358 PMCID: PMC4887934 DOI: 10.3892/ol.2016.4470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/05/2016] [Indexed: 01/29/2023] Open
Abstract
Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are the current standards methods for the determination of tissue human epidermal growth factor receptor 2 (HER2) status in gastric cancer, as for breast cancer. However, HER2-positive gastric cancer occasionally exhibits heterogeneous tissue HER2 overexpression, raising concern regarding false-negative results in unresectable cases diagnosed by biopsy samples. Serum HER2, the concentration of the extracellular domain of HER2 protein shed into the bloodstream, has the potential to supplement the use of IHC or FISH to determine HER2 status. However, the clinical significance of serum HER2 has not been well studied in gastric cancer. The present study describes an illustrative case of metastatic gastric cancer initially diagnosed as HER2-negative (IHC score 1+). The patient exhibited an elevated serum HER2 level, which prompted a reevaluation of the tissue by IHC, using an alternative antibody, and FISH; re-biopsy analyses confirmed the case as HER2-positive, and trastuzumab was subsequently added to the combination chemotherapy with capecitabine and cisplatin. Serum HER2 may aid in avoiding false-negative diagnoses of HER2 gastric cancer.
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Affiliation(s)
- Mayuko Saito
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Yujiro Kawakami
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Kentaro Yamashita
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Hiroshi Nasuno
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Y U Ishimine
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Koichiro Fukuda
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Hiroyuki Isshiki
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Ryo Suzuki
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Yoshiaki Arimura
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Yasuhisa Shinomura
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
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16
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Takahashi K, Nakagomi H, Inoue M, Nakayama Y, Furuya K, Maruyama M, Takano A, Sugai H, Hada M, Miyasaka Y, Amemiya K, Oyama T. Life-threatening metastasis was suppressed by trastuzumab containing regimen in a patient with Her2-negative breast cancer. Int Cancer Conf J 2015; 5:61-65. [PMID: 31149426 DOI: 10.1007/s13691-015-0228-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 06/11/2015] [Indexed: 10/23/2022] Open
Abstract
A 49-year-old female was referred to our hospital with left breast cancer and subsequently underwent mastectomy and axillary dissection. The pathological findings showed invasive breast cancer with lymph node metastasis (2/22), nuclear grade 3, ER (6+) PgR (2+) for the Allred score, and Her2 (2+) in an immunohistochemistry. We determined the subtype of Her2-negative breast cancer according to the fluorescent in situ hybridization results, as follows: Her2/CEP17 ratio 1.1 < 2.0. The patient received the EC regimen followed by docetaxel, and toremifene was subsequently administered. One year after the operation, the CA15-3 level was elevated at 50 ng/ml, and CT revealed liver metastases. Disease progression was not suppressed by paclitaxel containing regimen and eribulin. Then, we subsequently sought to determine whether the metastatic lesion showed the Her2 expression. Although the Her2 expression in the axillary lymph node metastases showed heterogeneous staining, the results were judged as Her2 (1+) according to the ASCO/CAP guidelines. We decided to administer trastuzumab and docetaxel due to the patient's life-threatening status, after which the CA15-3 level decreased and the symptom of fatigue improved. A total of 9 cycles of trastuzumab and docetaxel were administered, followed by maintenance trastuzumab continued to the present time. Physicians should be aware of the statement in the ASCO/CAP guidelines that the clinical decision to ultimately consider Her2-targeted therapy should be individualized according to the patient's status.
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Affiliation(s)
- Kazunori Takahashi
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Hiroshi Nakagomi
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Masayuki Inoue
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Yuko Nakayama
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Kazushige Furuya
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Masahiro Maruyama
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Atsushi Takano
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Hidemitsu Sugai
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Masao Hada
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Yoshiaki Miyasaka
- 1Department of Surgery, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Kenji Amemiya
- 2Department of Pathology, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
| | - Toshio Oyama
- 2Department of Pathology, Yamanashi Prefectural Central Hospital, Fujimi 1-1-1, Kofu, Yamanashi Japan
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17
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Di Gioia D, Dresse M, Mayr D, Nagel D, Heinemann V, Stieber P. Serum HER2 in combination with CA 15-3 as a parameter for prognosis in patients with early breast cancer. Clin Chim Acta 2014; 440:16-22. [PMID: 25444743 DOI: 10.1016/j.cca.2014.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 11/01/2014] [Accepted: 11/01/2014] [Indexed: 01/17/2023]
Abstract
AIM HER2 in breast cancer tissue is a marker of high prognostic and predictive relevance. Soluble HER2, the extracellular domain of the HER2/neu receptor (HER2 ECD), which is shed into the blood, has been suggested to be a helpful tumor marker. We investigated the relationship between the concentrations of HER2 ECD, CEA and CA 15-3, the association of these markers with clinicopathological features and the impact of HER2 ECD alone and in combination with known prognostic factors on disease free survival (DFS) and cancer specific survival (CSS) in untreated early breast cancer patients. PATIENTS AND METHODS HER2 ECD (ADVIA, Bayer), CEA (AxSYM, Abbott) and CA 15-3 (Elecsys, Roche) were measured at time of primary diagnosis in the pre-therapeutic (pre-operative) sera of 241 breast cancer patients and were correlated with clinicopathological parameters and outcome. RESULTS Higher HER2 ECD levels were significantly correlated with postmenopausal status (p=0.016) and tissue HER2-overexpression (p<0.0001). Higher serum levels of CA 15-3 were associated with larger tumor size (p=0.019), positive lymph nodes (p=0.019), UICC stage III (p<0.01), positive tissue HER2-overexpression (p<0.05) and negative hormone receptor status (p=0.016). In multivariate analysis, serum HER2 ECD levels, CA 15-3 levels, large tumor size and negative hormonal status were independent prognostic factors in DFS. Patients with both high levels of HER2 ECD (>15 ng/mL) and high serum levels of CA 15-3 (>24 U/mL) had the poorest prognosis with a DFS after 3 years of 50.0%. Patients without elevated serum levels had a better outcome with a DFS of 91.2%. CONCLUSIONS In our retrospective analysis, HER2 ECD and CA 15-3 were independent and better prognostic tools than HER2 in tissue. Prospective validation is necessary to confirm their usefulness in clinical practice.
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Affiliation(s)
- Dorit Di Gioia
- Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Campus Großhadern, 81377 Munich, Germany.
| | - Marie Dresse
- Institute of Laboratory Medicine, Ludwig-Maximilians-University of Munich, Campus Großhadern, 81377 Munich, Germany
| | - Doris Mayr
- Department of Pathology, Ludwig-Maximilians-University of Munich, 80337 Munich, Germany
| | - Dorothea Nagel
- Institute of Laboratory Medicine, Ludwig-Maximilians-University of Munich, Campus Großhadern, 81377 Munich, Germany
| | - Volker Heinemann
- Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Campus Großhadern, 81377 Munich, Germany
| | - Petra Stieber
- Institute of Laboratory Medicine, Ludwig-Maximilians-University of Munich, Campus Großhadern, 81377 Munich, Germany
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18
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Pukazhendhi G, Glück S. Circulating tumor cells in breast cancer. J Carcinog 2014; 13:8. [PMID: 25191136 PMCID: PMC4141360 DOI: 10.4103/1477-3163.135578] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/05/2014] [Indexed: 11/08/2022] Open
Abstract
Circulating tumor cell (CTC) measurement in peripheral blood of patients with breast cancer offers prognostic information. In this review, we will try to identify evidence that could be used for prognosis, predictive power to draw this tool to clinical utility. We reviewed 81 manuscripts, and categorized those in discovery datasets, prognostic factors in metastatic breast cancer, identification of clinical utility in early breast cancer and in novel approaches. With each patient responding differently to chemotherapy, more efficient markers would improve clinical outcome. Current CTC diagnostic techniques use epithelial markers predominantly; however, the most appropriate method is the measurement of circulating DNA. It has been hypothesized that micrometastasis occurs early in the development of tumors. That implies the presence of CTCs in nonmetastatic setting. The origin of stimulus for malignant transformation is yet unknown. The role of microenvironment as a stimulus is also being investigated. It has been shown that CTCs vary in numbers with chemotherapy. The markers, which are followed-up in the primary tumors, are also being studied on the CTCs. There is discordance of the human epidermal growth factor receptor-2 status between the primary tumor and CTCs. This review summarizes our current knowledge about the CTCs. With genetic profiling and molecular characterization of CTCs, it is possible to overcome the diagnostic difficulties. Evidence for clinical utility of CTC as prognostic and predictive marker is increasing. Appropriate patient stratification according to CTC determination among other tests, would make personalized cancer therapy more feasible.
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Affiliation(s)
- Geetha Pukazhendhi
- Department of Medicine, Hematology Oncology Division, Miller School of Medicine, Miami, FL, USA
| | - Stefan Glück
- Department of Medicine, Hematology Oncology Division, Miller School of Medicine, Miami, FL, USA ; Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
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19
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Di Gioia D, Dresse M, Mayr D, Nagel D, Heinemann V, Kahlert S, Stieber P. Serum HER2 supports HER2-testing in tissue at the time of primary diagnosis of breast cancer. Clin Chim Acta 2014; 430:86-91. [PMID: 24412321 DOI: 10.1016/j.cca.2013.12.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 12/13/2013] [Accepted: 12/25/2013] [Indexed: 10/25/2022]
Abstract
AIM HER2 in tissue is of high prognostic value. Soluble HER2, the extracellular domain (ECD), has been suggested to be a helpful biomarker. We investigated whether there is a relationship between HER2 ECD and HER2 in tissue and whether this relationship could be used for diagnostic purposes. METHODS HER2 ECD was measured in healthy individuals (N=283, 184 females, 99 males), in patients with history of breast cancer (BC) with no evidence of disease (N=249) as well as in BC patients before any treatment (N=565). HER2 in tissue was determined by immunohistochemistry and HER2 ECD was analyzed by immunoassay. RESULTS HER2 ECD levels were higher in healthy men than in healthy women (medians 12.9 ng/mL vs. 9.9 ng/mL, p<0.001). We observed an age dependency in women that means the older the women the higher the HER2 ECD level. In treated BC patients there was only a weak difference between younger and older women. For patients without distant metastases as well as patients with metastatic disease we observed a correlation of HER2 in serum and tissue. The median concentrations of HER2 ECD were 11.7 ng/mL (13.2 ng/mL) for the HER2-negative (HER2-positive) patients in the non-metastatic-group (p<0.001) and 11.9 ng/mL (16.0 ng/mL) in the metastatic-group (p=0.01). Using a cut-off of 30 ng/mL the HER2 in tissue was always positive, corresponding to a specificity of 99.8% and a sensitivity of 10.3%. CONCLUSIONS There is a strong correlation between HER2 ECD and HER2 in tissue. HER2 ECD supports the HER2 testing in tissue and may reveal false-negative tissue findings.
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Affiliation(s)
- Dorit Di Gioia
- Medical Department III, Klinikum Großhadern, University Hospital, Munich, Germany.
| | - Marie Dresse
- Institute of Clinical Chemistry, Klinikum Großhadern, University Hospital, Munich, Germany
| | - Doris Mayr
- Institute of Pathology, Klinikum Großhadern, University Hospital, Munich, Germany
| | - Dorothea Nagel
- Institute of Clinical Chemistry, Klinikum Großhadern, University Hospital, Munich, Germany
| | - Volker Heinemann
- Medical Department III, Klinikum Großhadern, University Hospital, Munich, Germany
| | - Steffen Kahlert
- Gynecological Department, Klinikum Großhadern, University Hospital, Munich, Germany
| | - Petra Stieber
- Institute of Clinical Chemistry, Klinikum Großhadern, University Hospital, Munich, Germany
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20
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Carney WP. Circulating oncoproteins HER2/neu, EGFR and CAIX (MN) as novel cancer biomarkers. Expert Rev Mol Diagn 2014; 7:309-19. [PMID: 17489737 DOI: 10.1586/14737159.7.3.309] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Pharmaceutical companies have developed targeted therapies such as trastuzumab and lapatinib for human epidermal growth factor receptor (HER)2/neu-positive tumors, while others have developed antiepidermal growth factor receptor (EGFR) therapies, such as tarceva and erbitux for EGFR-positive tumors. A drug called rencarex is targeted to an oncoprotein designated carbonic anhydrase IX (CAIX), which is being evaluated in renal cell carcinoma patients. Based on these targeted therapeutic approaches, this review describes clinical research studies performed with enzyme-linked immunosorbent assays specific for the circulating oncoproteins, HER2/neu, EGFR and CAIX. These circulating biomarkers have the potential to be used in conjunction with the specific targeted therapies for patient selection, monitoring and management. With the variety of new therapeutic options, the major challenge ahead will be to select the appropriate therapy or combinations of therapies for each patient. Specific biomarker tests, either alone or in panels, will be needed at the appropriate time in the course of disease to ensure that patients receive the right drug at the right time. These tests will also be valuable in monitoring the efficacy of the targeted therapies. A circulating biomarker such as serum HER2/neu may be able to specifically identify patients with progressing HER2/neu-positive disease and provide the information needed by physicians to choose from the variety of HER2/neu-targeted therapies that will soon be available to cancer patients.
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Affiliation(s)
- Walter P Carney
- Oncogene Science, Siemens Medical Solutions Diagnostics, Cambridge, MA 02142, USA.
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21
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Mahfoud OK, Rakovich TY, Prina-Mello A, Movia D, Alves F, Volkov Y. Detection of ErbB2: nanotechnological solutions for clinical diagnostics. RSC Adv 2014. [DOI: 10.1039/c3ra45401k] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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22
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Usefulness of traditional serum biomarkers for management of breast cancer patients. BIOMED RESEARCH INTERNATIONAL 2013; 2013:685641. [PMID: 24350285 PMCID: PMC3856124 DOI: 10.1155/2013/685641] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/06/2013] [Accepted: 09/09/2013] [Indexed: 12/30/2022]
Abstract
The measurement of serum tumor markers levels in breast cancer (BC) patients is an economic and noninvasive diagnostic assay frequently requested by clinical oncologists to get information about the presence or absence of disease as well as its evolution. Despite their wide use in clinical practice, there is still an intense debate between scientific organizations about the real usefulness for patient monitoring during followup as well as response to therapy evaluation in case of advanced BC. In this review, we want to highlight the current recommendations published by scientific organizations about the use of “established” BC serum markers (CEA, TPA, TPS, CIFRA-21, CA15-3, and s-HER2) in clinical oncology practice. Moreover, we will focus on recent papers evidencing the usefulness of tumor markers levels measurement as a guide for the prescription and diagnostic integration of molecular imaging exams such as those performed by hybrid 18-fluorofeoxyglucose-positron emission tomography with integrated computed tomography. This technology is nowadays able to detect early cancer lesions undetectable by conventional morphological imaging investigation and most likely responsible for increasing of serum tumor markers levels.
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Bechmann T, Madsen JS, Brandslund I, Lund ED, Ormstrup T, Jakobsen EH, Jylling AMB, Steffensen KD, Jakobsen A. Predicting brain metastases of breast cancer based on serum S100B and serum HER2. Oncol Lett 2013; 6:1265-1270. [PMID: 24179506 PMCID: PMC3813762 DOI: 10.3892/ol.2013.1536] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 07/12/2013] [Indexed: 01/01/2023] Open
Abstract
Brain metastases are a major cause of morbidity and mortality in breast cancer. The aim of the current study was to evaluate the prediction of brain metastases based on serum S100B and human epidermal growth factor receptor 2 (HER2). A total of 107 breast cancer patients were included in the current study from two prospective cohort studies with either elevated serum HER2 levels >15 ng/ml or brain metastases verified by magnetic resonance imaging (MRI) or computer tomography (CT). Following the exclusion of six patients, the remaining 101 patients were divided into two groups: Group 0 (n=55), patients with normal MRI results; and group 1 (n=46), patients with brain metastases. The levels of serum S100B and HER2 in the two groups were analyzed prior to MRI or CT of the brain, and no significant differences were identified in the serum HER2 (P=0.060) or S100B levels (P=0.623) between the groups. The univariate analysis of prognostic factors for brain metastases showed a significant correlation with systemic disease (P<0.001), axillary lymph node metastases (P=0.001) and serum HER2 >30 ng/ml (P=0.002). Only systemic disease (P<0.001) remained statistically significant in the multivariate analysis. In conclusion, serum levels of S100B and HER2 did not predict the risk of brain metastases. In the multivariate analysis, brain metastases were only found to correlate with systemic disease. However, in the univariate analysis, serum HER2 levels >30 ng/ml were identified to correlate with increased risk of brain metastases, which calls for further investigation.
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Affiliation(s)
- Troels Bechmann
- Faculty of Health Sciences, University of Southern Denmark, Odense 5000, Denmark ; Department of Oncology, Vejle Hospital, Vejle 7100, Denmark
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Serum HER-2: sensitivity, specificity, and predictive values for detecting metastatic recurrence in breast cancer patients. J Cancer Res Clin Oncol 2013; 139:1005-13. [DOI: 10.1007/s00432-013-1411-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 02/26/2013] [Indexed: 10/27/2022]
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Even-Desrumeaux K, Fourquet P, Secq V, Baty D, Chames P. Single-domain antibodies: a versatile and rich source of binders for breast cancer diagnostic approaches. MOLECULAR BIOSYSTEMS 2012; 8:2385-94. [PMID: 22772166 DOI: 10.1039/c2mb25063b] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Noninvasive early detection of breast cancer through the use of biomarkers is urgently needed since the risk of recurrence, morbidity, and mortality is closely related to disease stage at the time of primary surgery. A crucial issue in this approach is the availability of relevant markers and corresponding monoclonal antibodies suitable for the development of effective immunodiagnostic modalities. The identification of such markers from human pathological lesions and the isolation of specific antibodies using conventional approaches remain major challenges. Camelids produce functional antibodies devoid of light chains in which the single N-terminal domain of the heavy chain is fully capable of antigen binding. When produced as an independent domain, these so-called single-domain antibody fragments (sdAbs) or nanobodies have several advantages for biotechnological applications owing to their unique properties of size (13 kDa), stability, solubility, and expression yield. In this work, we have generated phage display libraries from animals immunized with breast cancer biopsies. These libraries were used to isolate sdAbs against known and relevant antigens such as HER2, or several cancer-specific sdAbs against unknown targets. We describe the identification of one these targets, cytokeratin 19, using affinity purification in combination with mass spectrometry. Some of these sdAbs were used in several straightforward diagnostic applications such as immunohistochemical analysis of tumor samples, multiplexed cytometric bead array analysis of crude samples, or an immune enrichment procedure of rare cells. Here, we demonstrate that phage display-based selection of single-domain antibodies is an efficient and high-throughput compatible approach to generate binders with excellent characteristics for the fast development of diagnostic and prognostic modalities.
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Developing an antibody-binding protein cage as a molecular recognition drug modular nanoplatform. Biomaterials 2012; 33:5423-30. [DOI: 10.1016/j.biomaterials.2012.03.055] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 03/15/2012] [Indexed: 11/21/2022]
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Tsé C, Gauchez AS, Jacot W, Lamy PJ. HER2 shedding and serum HER2 extracellular domain: Biology and clinical utility in breast cancer. Cancer Treat Rev 2012; 38:133-42. [DOI: 10.1016/j.ctrv.2011.03.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 03/28/2011] [Accepted: 03/31/2011] [Indexed: 01/29/2023]
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Abstract
The presence of circulating tumor cells (CTCs) in the blood as well as disseminated tumor cells (DTCs) in the bone marrow of breast cancer patients is associated with a worsened prognosis in the primary as well as in the metastatic situation. Next to their detection, evaluation of human epidermal growth factor receptor (HER2) expression is a valuable feature of CTCs/DTCs. As the HER2 status may change during disease progression CTCs/DTCs might (1) characterize the phenotype of minimal residual disease in the adjuvant setting and (2) serve as a "real time biopsy" of metastatic breast cancer. Phenotyping of CTCs/DTCs will thus help to understand mechanism of resistance to HER2-directed therapy. Moreover, patients that are likely to benefit from HER2-directed therapy despite a HER2-negative primary tumor might be identified.
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Ross JS. Update on HER2 testing for breast and upper gastrointestinal tract cancers. Biomark Med 2011; 5:307-18. [PMID: 21657840 DOI: 10.2217/bmm.11.31] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
With the regulatory approvals in Europe and the USA of trastuzumab-based anti-HER2 targeted therapy for upper gastrointestinal cancers in 2010, HER2 testing has now become universal for newly diagnosed cases of both breast cancer and adenocarcinomas of esophagus, stomach and gastroesophageal origin. In the 12 years or more since the approval of trastuzumab for breast cancer, general refinements in approaches to HER2 testing, including a greater understanding of the implications of preanalytic factors impacting the test results and the application of standardization of reporting of HER2 test results, have taken place. There has also been continuing development in breast cancer with the introduction of new HER2 tests, including non-FISH tests, dimerization assays, phosphorylated HER2 receptor tests, mRNA-based tests, HER2 gene sequencing tests and the application of HER2 testing to circulating tumor cells. Most recently, the introduction of HER2 testing for upper gastrointentinal malignancies has emphasized the need for performing and interpreting slide-based assays in a manner unique to these specimens and not to apply the breast cancer testing protocols to esophageal and gastric adenocarcinomas.
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Shi D, Bedford NM, Cho HS. Engineered multifunctional nanocarriers for cancer diagnosis and therapeutics. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2011; 7:2549-2567. [PMID: 21648074 DOI: 10.1002/smll.201100436] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 04/23/2011] [Indexed: 05/30/2023]
Abstract
This article reviews advances in the design and development of multifunctional carbon-based and/or magnetic nanoparticle systems (or simply 'nanocarriers') for early cancer diagnosis and spatially and temporally controlled therapy. The critical issues in cancer diagnosis and treatment are addressed based on novel nanotechnologies such as real-time in-vivo imaging, drug storage and release, and specific cancer-cell targeting. The implementation of nanocarriers into animal models and the subsequent effectiveness in treating tumors is also reviewed. Recommendations for future research are given.
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Affiliation(s)
- Donglu Shi
- The Institute for Advanced Materials and Nano Biomedicine, Tongji University, Shanghai 200092, China.
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Tan LD, Xu YY, Yu Y, Li XQ, Chen Y, Feng YM. Serum HER2 level measured by dot blot: a valid and inexpensive assay for monitoring breast cancer progression. PLoS One 2011; 6:e18764. [PMID: 21533253 PMCID: PMC3076436 DOI: 10.1371/journal.pone.0018764] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 03/17/2011] [Indexed: 11/25/2022] Open
Abstract
Human epidermal growth factor receptor 2 (HER2) is one of the most important
prognostic and predictive factors for breast cancer patients. Recently, serum
HER2 ECD level of patients detected by enzyme-linked immunoabsorbent assay
(ELISA) has been shown to predict tumor HER2 status and reveal its association
with tumor progression, recurrence and poor prognosis. In this study, we
established a new method, dot blot assay, to measure the serum HER2 level in
breast cancer patients and further to evaluate the clinical value for monitoring
breast cancer progression. We found that the serum HER2 level measured by dot
blot assay was significantly correlated with tissue HER2 status in breast cancer
patients (P = 0.001), and also
significantly correlated with HER2 level measured by ELISA
(P = 1.06×10−11).
Compared with ELISA method, the specificity and sensitivity of dot blot assay
were 95.3% and 65.0%, respectively. The serum HER2 levels of
patients with grade III or ER-negative were higher than those with grade
I–II (P = 0.004) and ER-positive
(P = 0.033), respectively. Therefore,
the novel dot blot method to detect serum HER2 level is a valid and inexpensive
assay with potential application in monitoring breast cancer progression in
clinical situations.
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Affiliation(s)
- Li-Duan Tan
- Department of Biochemistry and Molecular
Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin,
China
| | - Yuan-Yuan Xu
- Department of Biochemistry and Molecular
Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin,
China
| | - Yue Yu
- Department of Biochemistry and Molecular
Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin,
China
| | - Xiao-Qing Li
- Department of Biochemistry and Molecular
Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin,
China
- Key Laboratory of Breast Cancer Prevention and
Treatment of the Ministry of Education, Tianjin Medical University Cancer
Institute and Hospital, Tianjin, China
| | - Ying Chen
- Clinical Laboratory, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China
| | - Yu-Mei Feng
- Department of Biochemistry and Molecular
Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin,
China
- Key Laboratory of Breast Cancer Prevention and
Treatment of the Ministry of Education, Tianjin Medical University Cancer
Institute and Hospital, Tianjin, China
- * E-mail:
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Abstract
CONTEXT Molecular testing of solid tumors is steadily becoming a vital component of the contemporary anatomic pathologist's armamentarium. These sensitive and specific ancillary tools are useful for confirming ambiguous diagnoses suspected by light microscopy and for guiding therapeutic decisions, assessing prognosis, and monitoring patients for residual neoplastic disease after therapy. OBJECTIVE To review current molecular biomarkers and tumor-specific assays most useful in solid tumor testing, specifically of breast, colon, lung, thyroid, and soft tissue tumors, malignant melanoma, and tumors of unknown origin. A few upcoming molecular diagnostic assays that may become standard of care in the near future will also be discussed. DATA SOURCES Original research articles, review articles, and the authors' personal practice experience. CONCLUSIONS Molecular testing in anatomic pathology is firmly established and will continue to gain ground as the need for more specific diagnoses and new targeted therapies evolve. Knowledge of the more common and clinically relevant molecular tests available for solid tumor diagnosis and management, and their indications and limitations, is necessary if anatomic pathologists are to optimally use these tests and act as consultants for fellow clinicians directly involved in patient care.
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Affiliation(s)
- Anne Igbokwe
- Molecular Pathology Laboratory, BloodSource, Mather, CA 95655-4128, USA.
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Singhai R, Patil AV, Patil VW. Cancer biomarker HER-2/neu in breast cancer in Indian women. BREAST CANCER-TARGETS AND THERAPY 2011; 3:21-6. [PMID: 24367173 DOI: 10.2147/bctt.s17108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM AND OBJECTIVES In Indian women with breast cancer, the HER-2/neu gene is amplified in 30% of cases. Elevated serum HER-2/neu levels have been shown to be associated with a poor clinical prognosis and decreased survival in early stage breast cancer patients, and testing for this may help to manage the disease. The present study was therefore to estimate serum HER-2/neu levels in breast cancer patients and associate these with other prognostic factors. MATERIALS AND METHODS Serum HER-2/neu levels were studied in 207 patients with breast cancer, 15 with benign breast diseases, (BBD) and 175 age-matched healthy controls. Patients' age, menopausal status, node, and estrogen receptor (ER) and progesterone receptor (PgR) status were compared with serum HER-2/neu levels. RESULTS Serum HER-2/neu overexpression was associated with age, disease stage and positive nodal status but not with menopausal status. Serum HER-2/neu levels were negatively correlated with hormone receptor positivity. CONCLUSION HER-2/neu serum tests should be done more frequently in Indian women with breast cancer, irrespective of their ER and PgR hormone receptor status. ELISA is a reliable and economical tool to assess the HER-2/neu status in tumors, when breast tissue samples are not available.
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Affiliation(s)
- Rajeev Singhai
- Department of Biochemistry, Grant Medical College and Sir J J Group of Hospitals, Mumbai, India
| | - Amit V Patil
- Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
| | - Vinayak W Patil
- Department of Biochemistry, Grant Medical College and Sir J J Group of Hospitals, Mumbai, India
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Friel AM, Corcoran C, Crown J, O'Driscoll L. Relevance of circulating tumor cells, extracellular nucleic acids, and exosomes in breast cancer. Breast Cancer Res Treat 2010; 123:613-25. [PMID: 20549336 DOI: 10.1007/s10549-010-0980-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 06/02/2010] [Indexed: 12/17/2022]
Abstract
Early detection of cancer is vital to improved overall survival rates. At present, evidence is accumulating for the clinical value of detecting occult tumor cells in peripheral blood, plasma, and serum specimens from cancer patients. Both molecular and cellular approaches, which differ in sensitivity and specificity, have been used for such means. Circulating tumor cells and extracellular nucleic acids have been detected within blood, plasma, and sera of cancer patients. As the presence of malignant tumors are clinically determined and/or confirmed upon biopsy procurement-which in itself may have detrimental effects in terms of stimulating cancer progression/metastases-minimally invasive methods would be highly advantageous to the diagnosis and prognosis of breast cancer and the subsequent tailoring of targeted treatments for individuals, if reliable panels of biomarkers suitable for such an approach exist. Herein, we review the current advances made in the detection of such circulating tumor cells and nucleic acids, with particular emphasis on extracellular nucleic acids, specifically extracellular mRNAs and discuss their clinical relevance.
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Affiliation(s)
- Anne M Friel
- School of Pharmacy and Pharmaceutical Sciences & Molecular Therapeutics for Cancer Ireland, Trinity College Dublin, Dublin 2, Ireland
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Evaluation of tumor markers (HER-2/neu oncoprotein, CEA, and CA 15.3) in patients with locoregional breast cancer: prognostic value. Tumour Biol 2010; 31:171-80. [PMID: 20361287 DOI: 10.1007/s13277-010-0025-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Accepted: 03/01/2010] [Indexed: 10/19/2022] Open
Abstract
Tumor markers were studied in the sera of 883 untreated patients with primary breast cancer diagnosed between 1989 and 2007. Abnormal human epidermal growth factor receptor 2 (HER-2)/neu levels (>15 ng/mL) were found in 9.5%, carcinoembryonic antigen (CEA) in 15.9%, and cancer antigen (CA) 15.3 in 19.7% of the patients. One or more tumor markers were abnormal in 305 (34.5%) of the 883 studied patients. Significantly higher serum HER-2/neu levels were found in patients with tissue overexpression of this oncoprotein (p < 0.0001). CEA, CA 15.3, and HER-2/neu (only in those patients with tissue overexpression) serum levels were related with tumor stage (tumor size and nodal involvement) and steroid receptors (higher values in estrogen receptor-negative (ER-) tumors). Univariate analysis showed that HER-2/neu serum levels were prognostic factors in disease-free survival (DFS) and overall survival (OS) only in patients with tissue overexpression. Multivariate analysis in 834 patients show that nodal involvement, tumor size, ER, CEA, and adjuvant treatment were independent prognostic factors in DFS and OS. When only patients with HER-2/neu overexpression in tissue were studied, tumor size, nodal involvement, and tumor markers (one or another positive) were independent prognostic factors for both DFS and OS. HER-2/neu serum levels were also an independent prognostic factor, with CEA, ER, and nodes in 106 patients treated with neoadjuvant treatment. In summary, serum HER-2/neu, CEA, and CA 15.3 are useful tools in the prognostic evaluation of patients with primary breast cancer.
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Spector NL, Blackwell KL. Understanding the mechanisms behind trastuzumab therapy for human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 2009; 27:5838-47. [PMID: 19884552 DOI: 10.1200/jco.2009.22.1507] [Citation(s) in RCA: 356] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Targeted therapy with the humanized monoclonal antibody trastuzumab has become a mainstay for human epidermal growth factor receptor 2 (HER2) -positive breast cancer (BC). The mechanisms of action of trastuzumab have not been fully elucidated, and data available to date are reviewed here. The impact of the mechanisms of action on clinical benefit also is discussed. METHODS An extensive literature review of trastuzumab and proposed mechanisms of action was performed. RESULTS At least five potential extracellular and intracellular antitumor mechanisms of trastuzumab have been identified in the preclinical setting. These include activation of antibody-dependent cellular cytotoxicity, inhibition of extracellular domain cleavage, abrogation of intracellular signaling, reduction of angiogenesis, and decreased DNA repair. These effects lead to tumor cell stasis and/or death. Clinical benefit from trastuzumab-based therapy in both early and advanced BC has been demonstrated. The benefit of trastuzumab use beyond progression has also been shown, which indicates the need for continuous suppression of the HER2 pathway. Targeting both HER2, with various approaches, and other pathways may enhance the clinical benefit observed with trastuzumab and overcome potential resistance. Novel combinations include pertuzumab (a HER2 dimerization inhibitor), lapatinib (a HER1/HER2 tyrosine kinase inhibitor), bevacizumab (an antiangiogenic agent), tanespimycin (a heat shock protein inhibitor), antiestrogen therapies, and an antibody-drug conjugate (trastuzumab-DM1). CONCLUSION Trastuzumab is the foundation of care for patients with HER2-positive BC. Emerging data from studies of other targeted agents may provide alternative treatment combinations to maximize the clinical benefit from trastuzumab and prevent or delay resistance. The continued development of trastuzumab highlights promising treatment approaches for the future.
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Affiliation(s)
- Neil L Spector
- Duke Translational Research Oncology Program, Duke University Hospital, Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, NC 27710, USA.
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Finn RS, Gagnon R, Di Leo A, Press MF, Arbushites M, Koehler M. Prognostic and predictive value of HER2 extracellular domain in metastatic breast cancer treated with lapatinib and paclitaxel in a randomized phase III study. J Clin Oncol 2009; 27:5552-8. [PMID: 19858400 DOI: 10.1200/jco.2008.21.1763] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The HER2 extracellular domain (ECD) is enzymatically cleaved from the cell membrane. Shed ECD in serum has been studied as both prognostic and predictive markers. Lapatinib is a dual inhibitor of HER2 and epidermal growth factor receptor kinases. We examined the prognostic and predictive role of HER2 ECD in a randomized trial of paclitaxel with placebo or lapatinib in women with HER2-negative or -unknown breast cancer. PATIENTS AND METHODS Patients (n = 579) with newly diagnosed metastatic breast cancer (MBC) were randomly assigned to paclitaxel with placebo or lapatinib. HER2 status was determined centrally. ECD was centrally measured by enzyme linked immunoassay in available samples at baseline (b; n = 472), week 9, and every 12 weeks thereafter. Results were correlated to overall response rate (ORR) and progression-free survival (PFS). RESULTS Elevated baseline ECD (bECD) levels (>or= 16 ng/mL) did not predict HER2 tumor status (sensitivity, 62%; specificity, 75%). In HER2-negative tumors, elevated bECD was not correlated with improved efficacy for lapatinib plus paclitaxel versus placebo plus paclitaxel (ORR: odds ratio, 1.6; 95% CI, 0.1 to 3.8; P = .365; PFS: hazard ratio, 0.94; 95% CI, 0.60 to 1.47; P = .797). ECD levels tended to decrease over time when bECD was elevated. ECD conversion from low to high was associated with worse PFS. Converting from high to low was associated with a better PFS. A consistently low ECD level had better PFS than a consistently elevated ECD. All associations were found to be independent of lapatinib. CONCLUSION HER2 bECD does not predict lapatinib benefit in patients with HER2-negative MBC. Changes in ECD status correlates with patient outcome regardless of treatment given. Measuring HER2 ECD is not currently recommended for predicting benefit to lapatinib.
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Affiliation(s)
- Richard S Finn
- Geffen School of Medicine at UCLA, Norris Cancer Center, University of Southern California, Los Angeles, CA 90095, usa.
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Ross JS, Slodkowska EA, Symmans WF, Pusztai L, Ravdin PM, Hortobagyi GN. The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist 2009; 14:320-68. [PMID: 19346299 DOI: 10.1634/theoncologist.2008-0230] [Citation(s) in RCA: 836] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The human epidermal growth factor receptor (HER-2) oncogene encodes a transmembrane tyrosine kinase receptor that has evolved as a major classifier of invasive breast cancer and target of therapy for the disease. The validation of the general prognostic significance of HER-2 gene amplification and protein overexpression in the absence of anti-HER-2 targeted therapy is discussed in a study of 107 published studies involving 39,730 patients, which produced an overall HER-2-positive rate of 22.2% and a mean relative risk for overall survival (OS) of 2.74. The issue of HER-2 status in primary versus metastatic breast cancer is considered along with a section on the features of metastatic HER-2-positive disease. The major marketed slide-based HER-2 testing approaches, immunohistochemistry, fluorescence in situ hybridization, and chromogenic in situ hybridization, are presented and contrasted in detail against the background of the published American Society of Clinical Oncology-College of American Pathologists guidelines for HER-2 testing. Testing issues, such as the impact of chromosome 17 polysomy and local versus central HER-2 testing, are also discussed. Emerging novel HER-2 testing techniques, including mRNA-based testing by real-time polymerase chain reaction and DNA microarray methods, HER-2 receptor dimerization, phosphorylated HER-2 receptors, and HER-2 status in circulating tumor cells, are also considered. A series of biomarkers potentially associated with resistance to trastuzumab is discussed with emphasis on the phosphatase and tensin homologue deleted on chromosome ten/Akt and insulin-like growth factor receptor pathways. The efficacy results for the more recently approved small molecule HER-1/HER-2 kinase inhibitor lapatinib are also presented along with a more limited review of markers of resistance for this agent. Additional topics in this section include combinations of both anti-HER-2 targeted therapies together as well as with novel agents including bevacizumab, everolimus, and tenespimycin. A series of novel HER-2-targeting agents is also presented, including pertuzumab, ertumaxomab, HER-2 vaccines, and recently discovered tyrosine kinase inhibitors. Biomarkers predictive of HER-2 targeted therapy toxicity are included, and the review concludes with a consideration of HER-2 status in the prediction of response to non-HER-2 targeted treatments including hormonal therapy, anthracyclines, and taxanes.
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Affiliation(s)
- Jeffrey S Ross
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY 12208, USA.
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Aalinkeel R, Bindukumar B, Reynolds JL, Sykes DE, Mahajan SD, Chadha KC, Schwartz SA. The dietary bioflavonoid, quercetin, selectively induces apoptosis of prostate cancer cells by down-regulating the expression of heat shock protein 90. Prostate 2008; 68:1773-89. [PMID: 18726985 PMCID: PMC2826114 DOI: 10.1002/pros.20845] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Human and animal studies have suggested that diet-derived flavonoids, in particular quercetin may play a beneficial role by preventing or inhibiting oncogenesis, but the underlying mechanism remains unclear. The aim of this study is to evaluate the effect(s) of quercetin on normal and malignant prostate cells and to identify the target(s) of quercetin's action. METHODOLOGY We addressed this question using cells in culture and investigated whether quercetin affects key biological processes responsible for tumor cell properties such as cell proliferation and apoptosis and also studied the effect of quercetin on the proteome of prostate cancer cells using difference gel electrophoresis (DIGE) to assess changes in the expression of relevant proteins. RESULTS Our findings demonstrate that quercetin treatment of prostate cancer cells results in decreased cell proliferation and viability. Furthermore, we demonstrate that quercetin promotes cancer cell apoptosis by down-regulating the levels of heat shock protein (Hsp) 90. Depletion of Hsp90 by quercetin results in decreased cell viability, levels of surrogate markers of Hsp90 inhibition (intracellular and secreted), induced apoptosis and activation of caspases in cancer cells but not in normal prostate epithelial cells. Knockdown of Hsp90 by short interfering RNA also resulted in induction apoptosis similar to quercetin in cancer cells as indicated by annexin V staining. CONCLUSION Our results demonstrate that quercetin down-regulates the expression of Hsp90 which, in turn, induces inhibition of growth and cell death in prostate cancer cells while exerting no quantifiable effect on normal prostate epithelial cells.
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Affiliation(s)
- Ravikumar Aalinkeel
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, State University of New York at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, New York
| | - B. Bindukumar
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, State University of New York at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, New York
| | - Jessica L. Reynolds
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, State University of New York at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, New York
| | - Donald E. Sykes
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, State University of New York at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, New York
| | - Supriya D. Mahajan
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, State University of New York at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, New York
| | - Kailash C. Chadha
- Department of Molecular and Cellular Biology, Roswell Park Cancer Institute, Buffalo, New York
| | - Stanley A. Schwartz
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, State University of New York at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, New York
- Correspondence to: Stanley A. Schwartz, MD, PhD, Buffalo General, Hospital/SUNY Buffalo, Division of Allergy, Immunology and, Rheumatology, Department of Medicine, 100 High Street, Buffalo, NY 14203.
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40
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The prognostic and predictive values of circulating HER-2/neu extracellular domain in patients with metastatic breast cancer. Breast Cancer Res Treat 2008; 114:513-5. [DOI: 10.1007/s10549-008-0145-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 07/18/2008] [Indexed: 11/27/2022]
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41
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Changes over time of extracellular domain of HER2 (ECD/HER2) serum levels have prognostic value in metastatic breast cancer. Breast Cancer Res Treat 2008; 114:503-11. [DOI: 10.1007/s10549-008-0033-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2007] [Accepted: 04/16/2008] [Indexed: 11/26/2022]
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Addressing the future: combination with targeted therapies, adjuvant setting and beyond. Anticancer Drugs 2008; 19 Suppl 2:S3-5. [DOI: 10.1097/01.cad.0000251435.77758.82] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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43
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Azambuja E, Durbecq V, Rosa DD, Colozza M, Larsimont D, Piccart-Gebhart M, Cardoso F. HER-2 overexpression/amplification and its interaction with taxane-based therapy in breast cancer. Ann Oncol 2007; 19:223-32. [PMID: 17872901 DOI: 10.1093/annonc/mdm352] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Breast cancer (BC) is the most common cancer in women and it is incurable when metastases are diagnosed. Taxanes, namely docetaxel and paclitaxel, are effective chemotherapeutic agents in the metastatic, neoadjuvant and adjuvant settings. HER-2 overexpression/amplification is detected in 25-30% of BCs and confers aggressive tumor behavior as well as resistance to some systemic treatments; nevertheless, its association with response to taxane-based chemotherapy is still unclear, with conflicting results in both in vitro and in vivo preclinical studies. This review will address the impact of HER-2 overexpression/amplification in BC patients treated with taxanes. Prospective, randomized trials incorporating important biological hypotheses are either ongoing or just closed, and their results will hopefully help to shed more light on this issue.
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MESH Headings
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Biomarkers, Tumor/analysis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/mortality
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant
- Clinical Trials, Phase II as Topic
- Clinical Trials, Phase III as Topic
- Drug Resistance, Neoplasm
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Mastectomy/methods
- Neoplasm Staging
- Paclitaxel/administration & dosage
- Predictive Value of Tests
- Prognosis
- Randomized Controlled Trials as Topic
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/metabolism
- Risk Assessment
- Sensitivity and Specificity
- Survival Analysis
- Taxoids/administration & dosage
- Trastuzumab
- Treatment Outcome
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Affiliation(s)
- E Azambuja
- Department of Medical Oncology and Translational Research Unit-Jules Bordet Institute, Brussels, Belgium
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Carney WP, Leitzel K, Ali S, Neumann R, Lipton A. HER-2/neu diagnostics in breast cancer. Breast Cancer Res 2007; 9:207. [PMID: 17561991 PMCID: PMC1929087 DOI: 10.1186/bcr1664] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
HER-2/neu status of the primary breast cancer (PBC) is determined by immunohistochemistry and fluorescent in situ hybridization. Because of a variety of technical factors, however, the PBC may not accurately reflect the metastatic tumor in terms of HER-2/neu status. Recently published guidelines recommend that tumors be defined as HER-2/neu positive if 30% or more of the cells are 3+. Circulating levels of the HER-2 extracellular domain can be measured in serum using a test cleared by the US Food and Drug Administration, and increased serum HER-2/neu levels to above 15 ng/ml can reflect tumor progression. Studies comparing tissue HER-2/neu status of the PBC and HER-2/neu levels above 15 ng/ml in metastatic breast cancer patients are also reviewed.
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Affiliation(s)
- Walter P Carney
- Oncogene Science, Siemens Medical Solutions Diagnostics, Rogers Street, Cambridge, Massachusetts 02142, USA.
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45
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Mazouni C, Hall A, Broglio K, Fritsche H, Andre F, Esteva FJ, Hortobagyi GN, Buzdar AU, Pusztai L, Cristofanilli M. Kinetics of serum HER-2/neu changes in patients with HER-2-positive primary breast cancer after initiation of primary chemotherapy. Cancer 2007; 109:496-501. [PMID: 17149760 DOI: 10.1002/cncr.22418] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of the study was to determine the utility of quantitation of the extracellular domain (ECD) of the HER-2/neu receptor in the serum for predicting response to treatment in patients with primary breast cancer receiving neoadjuvant therapy. METHODS HER-2/neu ECD was measured in sera obtained from 39 patients with HER-2-amplified stage II-III primary breast cancer undergoing neoadjuvant chemotherapy. Patients were randomly assigned to either 4 cycles of paclitaxel followed by 4 cycles of fluorouracil, epirubicin, and cyclophosphamide (FEC) (n = 10) or to the same chemotherapy with simultaneous weekly trastuzumab for 24 weeks (n = 29). Changes in HER-2 ECD were monitored with the Bayer HER-2/neu assay over 6 months and correlated with pathological response to treatment. RESULTS Before initiation of chemotherapy, 28.2% of patients had elevated concentration of the HER-2 ECD (>15 ng/mL). The median baseline serum HER-2 ECD concentration was 13.6 ng/mL (mean +/- SD, 20.3 +/- 35.5 ng/mL). A decrease in the median HER-2 ECD levels from baseline to Week 3 and from baseline to Week 6 of chemotherapy was seen regardless of treatment regimen. No significant difference in baseline HER-2 ECD levels was observed between the groups who achieved pathological complete response (pCR) and the group with residual disease (P = .41). However, a 9% drop from Week 3 to Week 6 after initial chemotherapy was predictive of pCR (P = .04). CONCLUSION A decrease in serum HER-2 ECD levels early during treatment was associated with pathological response in patients receiving primary chemotherapy, particularly trastuzumab-based regimens. Serum HER-2 ECD levels may serve to monitor neoadjuvant therapy in HER-2-positive primary breast cancer.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- Breast Neoplasms/blood
- Breast Neoplasms/drug therapy
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Lobular/blood
- Carcinoma, Lobular/drug therapy
- Cyclophosphamide/administration & dosage
- Epirubicin/administration & dosage
- Female
- Fluorouracil/administration & dosage
- Humans
- Kinetics
- Middle Aged
- Neoadjuvant Therapy
- Prognosis
- Prospective Studies
- Receptor, ErbB-2/blood
- Trastuzumab
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Affiliation(s)
- Chafika Mazouni
- Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77230-1439, USA
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46
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Berent R, Auer J, Porodko M, Lamm G, Weber T, Wimmer E, Seier J, Aspöck G, Eber B. Influence of cardiopulmonary resuscitation on levels of tumour markers. Eur J Cancer Care (Engl) 2007; 15:252-6. [PMID: 16882121 DOI: 10.1111/j.1365-2354.2005.00648.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Tumour markers (TM), including alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen (CA) 15-3 and prostate-specific antigen (PSA), are serum markers for malignant diseases. Previous studies investigating the effect of acute and chronic inflammation, cardiopulmonary bypass surgery and cardiopulmonary resuscitation (CPR) on levels of TM showed conflicting results. Cardiopulmonary resuscitation (CPR) may result in a profound inflammatory response, and is frequently associated with severe tissue hypoperfusion. The present study investigated whether AFP, CEA, CA 15-3 and PSA are influenced by CPR. Alpha-fetoprotein (AFP), CEA, CA 15-3 and PSA (only in male patients) were assessed immediately after hospital admission, 6 h, 12 h and 2 days after prolonged CPR in eight male and 12 female patients. Serum levels of AFP, CEA, CA 15-3 did not change significantly after CPR. Prostate-specific antigen (PSA) levels increased significantly with a highest level in the study period 48 h after CPR (3.3 +/- 3.1 and 28.3 +/- 30.5 ng/mL for baseline and 48 h levels, respectively; P < 0.001). Alpha-fetoprotein (AFP), CEA, CA 15-3 and PSA (in men) values above the normal range were observed in 0%, 13.8%, 3.8% and 46.9% of all measurements respectively. At least one value above the normal range were observed in 0%, 20%, 5% and 75% of all patients for AFP, CEA, CA 15-3 and PSA (in men) respectively. Baseline values of AFP, CEA, CA 15-3 and PSA (in men) were above the normal range in 0%, 15%, 5% and 10% of all patients respectively. Levels for all markers did not differ significantly between survivors and non-survivors. In conclusion, prolonged CPR does not influence AFP, CEA, CA 15-3 serum levels, but is frequently associated with increases of PSA. Thus, in contrast to PSA, interpretation of AFP, CEA, CA 15-3 serum levels is not influenced by recent CPR.
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Affiliation(s)
- R Berent
- Department of Cardiology and Intensive Care, General Hospital Wels, Wels, Austria
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47
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Colomer R, Llombart-Cussac A, Lloveras B, Ramos M, Mayordomo JI, Fernández R, Tusquets I, Gil M, Barnadas A, Constenla M, Gilabert M, Alba E. High circulating HER2 extracellular domain levels correlate with reduced efficacy of an aromatase inhibitor in hormone receptor-positive metastatic breast cancer: A confirmatory prospective study. Cancer 2007; 110:2178-85. [DOI: 10.1002/cncr.23043] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wülfing P, Borchard J, Buerger H, Heidl S, Zänker KS, Kiesel L, Brandt B. HER2-positive circulating tumor cells indicate poor clinical outcome in stage I to III breast cancer patients. Clin Cancer Res 2006; 12:1715-20. [PMID: 16551854 DOI: 10.1158/1078-0432.ccr-05-2087] [Citation(s) in RCA: 212] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE Early metastasis in node-negative breast cancer indicates that breast cancer cells obviously can bypass the lymph nodes and disseminate directly hematogenous to distant organs. For this purpose, we evaluated the prognostic value of blood-borne, HER2-positive circulating tumor cells (CTC) in the peripheral blood from 42 breast cancer patients with a median follow-up of 95 months. EXPERIMENTAL DESIGN Cells were isolated by the patented combined buoyant density gradient and immunomagnetic separation procedure and analyzed by immunocytochemistry. RESULTS We detected one to eight CTCs in the peripheral blood of 17 of 35 patients (48.6%) presenting no overt metastasis. As a positive control, 7 of 7 (100%) patients with metastatic disease presented positive. Healthy persons and patients (n = 32) operated for nonmalignant diseases presented negative for CTCs. The presence and frequency of HER2-positive CTCs correlated with a significantly decreased disease-free survival (P < 0.005) and overall survival (P < 0.05). Interestingly, in 12 patients with HER2-positive CTCs, the primary tumor was negative for HER2 as assessed by immunohistochemical score and fluorescence in situ hybridization. CONCLUSIONS This study provides some evidence of a prognostic effect of HER2-positive CTCs in stage I to III breast cancer. Future studies have to determine the outcome of patients treated with HER2-targeting therapies with respect to HER2-positive CTC levels because it is not unlikely that high levels of HER2-positive CTCs reflect the activity of the tumor and may predict response to trastuzumab.
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Affiliation(s)
- Pia Wülfing
- Department of Obstetrics and Gynecology, Gerhard-Domagk Institute of Pathology, and Institute of Clinical Chemistry and Laboratory Medicine, University of Münster, Münster, Germany.
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Hood BL, Conrads TP, Veenstra TD. Mass spectrometric analysis of formalin-fixed paraffin-embedded tissue: unlocking the proteome within. Proteomics 2006; 6:4106-14. [PMID: 16800036 DOI: 10.1002/pmic.200600016] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The predominance of tissues stored worldwide in hospitals and clinical laboratories exist in formalin-fixed paraffin-embedded (FFPE) blocks that are generated by simple and well-established protocols. Although generation of FFPE tissues has facilitated their characterization by such techniques as histopathology, they have proven refractory to biomarker discovery investigations using state-of-the-art MS-based proteomic methodologies. Very recently new methods have been developed that enable proteins extracted from FFPE tissues to be analyzed by MS. This review will highlight and discuss those efforts that have led to this exciting recent progress. Although these developments are quite new, the ability to conduct MS-based proteomic analyses of FFPE tissues opens heretofore intractable clinical samples for discovery-based biomarker research.
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Affiliation(s)
- Brian L Hood
- Laboratory of Proteomics and Analytical Technologies, SAIC-Frederick, Inc., National Cancer Institute, Frederick, MD 21702, USA
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50
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Namer M, Gligorov J, Luporsi E, Serin D. Breast cancer clinical practice recommendations from Saint-Paul-de-Vence: excerpts concerning targeted therapies. Target Oncol 2006. [DOI: 10.1007/s11523-006-0033-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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