Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
J Breast Cancer. 2012 Jun;15(2):189-96. doi: 10.4048/jbc.2012.15.2.189. Epub 2012 Jun 28.
Little information exists about the possible influence of serum HER2/neu on response to chemotherapy. We propose that the assessment of serum HER2/neu in a pretreatment serum sample may be useful in predicting response to neoadjuvant chemotherapy.
All breast cancer patients were tested by immunohistochemical stain and fluorescent in situ hybridization for HER2/neu before treatment. Serum HER2/neu was twice measured by chemiluminescence immunoassay (ADVIA Centaur System) before neoadjuvant chemotherapy and before operation. The cut-off value was 10.2 mg/mL, according to the previous study. Pathologic complete response (pCR) was considered as no residual tumor or remnant ductal carcinoma in situ; partial response (PR) was a less than 50% decrease in maximal diameter in pathologic tumor size. The measurements for the changes of serum HER2/neu were defined as pretreatment HER2/neu-preoperation HER2/neu. We compared the change of serum HER2/neu between that from before chemotherapy and that after chemotherapy, the pathologic complete response and partial response, and the trastuzumab group and anthracycline group.
Serum HER2/neu was decreased after neoadjuvant chemotherapy. The mean of serum HER2/neu in prechemotherapy was 15.4±9.0 ng/mL, and that of postchemotherapy was 10.5±2.0 ng/mL (p=0.04). Pathologic response was correlated with the change of serum HER2/neu (PR, 11.7±2.2 ng/mL vs. pCR, 23.7±13.1 ng/mL; p=0.01). In the trastuzumab group, pCR was marginally correlated with the change of serum HER2/neu (PR, 0.8±0.84 ng/mL vs. pCR, 21.1±13.2 ng/mL; p=0.08).
Serum HER2/neu levels during treatment were associated with pathologic response in patients receiving neoadjuvant chemotherapy, particularly, in a trastuzumab-based regimen. The change of serum HER2/neu levels may serve in monitoring neoadjuvant therapy in HER2/neu-overexpressed breast cancer.
关于血清 HER2/neu 对化疗反应的可能影响，相关信息较少。我们提出，在预处理血清样本中评估血清 HER2/neu 可能有助于预测新辅助化疗的反应。
所有乳腺癌患者在治疗前均通过免疫组织化学染色和荧光原位杂交检测 HER2/neu。在新辅助化疗前和手术前，两次通过化学发光免疫测定法（ADVIA Centaur System）测量血清 HER2/neu。根据先前的研究，将截断值设定为 10.2mg/mL。病理完全缓解（pCR）被认为是无残留肿瘤或残余导管原位癌；部分缓解（PR）是指病理肿瘤大小的最大直径减少小于 50%。血清 HER2/neu 变化的测量定义为预处理 HER2/neu-手术前 HER2/neu。我们比较了新辅助化疗前后血清 HER2/neu 的变化、病理完全缓解和部分缓解以及曲妥珠单抗组和蒽环类药物组之间的变化。
新辅助化疗后血清 HER2/neu 降低。化疗前血清 HER2/neu 的平均值为 15.4±9.0ng/mL，化疗后为 10.5±2.0ng/mL（p=0.04）。病理反应与血清 HER2/neu 的变化相关（PR，11.7±2.2ng/mL 与 pCR，23.7±13.1ng/mL；p=0.01）。在曲妥珠单抗组中，pCR 与血清 HER2/neu 的变化略有相关性（PR，0.8±0.84ng/mL 与 pCR，21.1±13.2ng/mL；p=0.08）。
接受新辅助化疗的患者在治疗过程中血清 HER2/neu 水平与病理反应相关，尤其是在曲妥珠单抗为基础的治疗方案中。血清 HER2/neu 水平的变化可能有助于监测 HER2/neu 过表达乳腺癌的新辅助治疗。
