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曲妥珠单抗治疗失败后 HER2 成为结直肠癌治疗的新兴靶点

HER2 as an Emerging Oncotarget for Colorectal Cancer Treatment After Failure of Anti-Epidermal Growth Factor Receptor Therapy.

机构信息

Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan.

Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan.

出版信息

Clin Colorectal Cancer. 2017 Dec;16(4):247-251. doi: 10.1016/j.clcc.2017.03.001. Epub 2017 Mar 9.

Abstract

Amplification of the HER2 gene is an indicator of poor prognosis for several kinds of malignancies such as breast and gastric cancer, and anti-HER2 targeting therapies provide clinical benefits in these patients. In 2011, HER2 was identified as a resistance molecule for de novo and secondary anti-epidermal growth factor receptor (EGFR) antibody therapy. HER2 activation provides a bypass signaling pathway after anti-EGFR antibody treatment of colorectal cancer. Cell line-based screening revealed that HER2 genomic amplification induces resistance to the anti-EGFR antibody cetuximab in colorectal cancer. Recently, HER2 itself has been recognized as a target for oncotherapy in colorectal cancer. The first part of this review provides an update on the present state of knowledge about the role of HER2 in colorectal cancer, including its prognostic relevance and role in resistance to anti-EGFR antibody treatment. In the second part of the review, we discuss the results of preclinical and clinical studies that examined the potential utility of anti-HER2 targeted therapy in colorectal cancer. Although it acts as a barrier for other molecular targeting agents such as cetuximab, HER2 itself is a promising target for oncotherapy. Current research indicates that anti-HER2 drugs will be developed further and introduced into clinical practice for the treatment of patients with HER2-positive colorectal cancer.

摘要

HER2 基因扩增是多种恶性肿瘤(如乳腺癌和胃癌)预后不良的指标,抗 HER2 靶向治疗为这些患者提供了临床获益。2011 年,HER2 被确定为新型和继发性抗表皮生长因子受体(EGFR)抗体治疗的耐药分子。HER2 激活为结直肠癌抗 EGFR 抗体治疗后提供了旁路信号通路。基于细胞系的筛选表明,HER2 基因组扩增导致结直肠癌对抗 EGFR 抗体西妥昔单抗产生耐药性。最近,HER2 本身已被认为是结直肠癌肿瘤治疗的靶点。本综述的第一部分提供了关于 HER2 在结直肠癌中的作用的最新知识状态,包括其预后相关性和对抗 EGFR 抗体治疗耐药性的作用。在综述的第二部分,我们讨论了探讨抗 HER2 靶向治疗在结直肠癌中潜在应用的临床前和临床研究结果。虽然 HER2 作为其他分子靶向药物(如西妥昔单抗)的屏障,但它本身是肿瘤治疗的一个有前途的靶点。目前的研究表明,抗 HER2 药物将进一步开发并引入临床实践,用于治疗 HER2 阳性结直肠癌患者。

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