Xu Chen, Liu Yalan, Jiang Dongxian, Li Qian, Ge Xiaowen, Zhang Ying, Huang Jie, Su Jieakesu, Ji Yuan, Hou Jun, Lu Shaohua, Hou Yingyong, Liu Tianshu
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Pathology, School of Basic Medical Sciences and Zhongshan Hospital, Fudan University, Shanghai, China.
Oncotarget. 2017 May 16;8(20):33185-33196. doi: 10.18632/oncotarget.16567.
Factors affecting trastuzumab efficacy in advanced gastric cancer (GC) are largely unknown. Heterogeneity is a notable feature of HER2 in GC. Whether the heterogeneity influences trastuzumab efficacy is still unknown.
The HER2homogeneous group and HER2heterogeneous group showed no statistical difference in RR (46.4% vs 55.0%, P = 0.558), PFS (5.80 vs 6.30 months, P = 0.804) and OS (16.00 vs 16.00 months, P = 0.787). The Laurenintestinal group and Laurennon-intestinal group demonstrated no discrepancy in PFS (6.00 vs 6.00 months, P = 0.912) and OS (16.50 vs 14.00 months, P = 0.227). However, by combining HER2 heterogeneity and Lauren classification, PFS and OS of HER2homogeneous/Laurennon-intestinal subgroup was the shortest among the 4 subgroups (P = 0.012 and P = 0.037), which was much shorter than the other patients (PFS:3.00 vs 6.30 months, P = 0.003; OS: 4.50 vs 16.50 months, P = 0.004). Univariate and multivariate analysis showed that HER2 heterogeneity combined with Lauren classification was an independent prognostic factor in both PFS (P = 0.031 and P = 0.002) and OS (P = 0.039 and P = 0.013).
48 patients with HER2 positive advanced GCs accepting trastuzumab treatment were retrospectively analyzed. Based on HER2 heterogeneity, the patients were divided into a HER2homogeneous group and a HER2heterogeneous group. Response rate (RR), progression free survival (PFS), and overall survival (OS) were compared. Main clinicopathological factors including Lauren classification were subjected to subgroup analysis.
HER2 heterogeneity alone may not correlate with trastuzumab efficacy in HER2 positive advanced GCs. HER2 heterogeneity combined with Lauren classification may help to identify a subgroup with poor response to trastuzumabx which is homogeneous HER2 positive and non-intestinal type.
影响曲妥珠单抗治疗晚期胃癌（GC）疗效的因素大多未知。异质性是胃癌中HER2的一个显著特征。这种异质性是否会影响曲妥珠单抗的疗效仍不清楚。
HER2同质组和HER2异质组在缓解率（RR）（46.4%对55.0%，P = 0.558）、无进展生存期（PFS）（5.80对6.30个月，P = 0.804）和总生存期（OS）（16.00对16.00个月，P = 0.787）方面无统计学差异。Lauren肠型组和Lauren非肠型组在PFS（6.00对6.00个月，P = 0.912）和OS（16.50对14.00个月，P = 0.227）方面无差异。然而，将HER2异质性与Lauren分类相结合后，HER2同质/Lauren非肠型亚组的PFS和OS在4个亚组中最短（P = 0.012和P = 0.037），远短于其他患者（PFS：3.00对6.30个月，P = 0.003；OS：4.50对16.50个月，P = 0.004）。单因素和多因素分析表明，HER2异质性与Lauren分类相结合在PFS（P = 0.031和P = 0.002）和OS（P = 0.039和P = 0.013）方面均为独立的预后因素。
回顾性分析48例接受曲妥珠单抗治疗的HER2阳性晚期胃癌患者。根据HER2异质性，将患者分为HER2同质组和HER2异质组。比较缓解率（RR）、无进展生存期（PFS）和总生存期（OS）。对包括Lauren分类在内的主要临床病理因素进行亚组分析。
单独的HER2异质性可能与HER2阳性晚期胃癌中曲妥珠单抗的疗效无关。HER2异质性与Lauren分类相结合可能有助于识别出对曲妥珠单抗反应较差的亚组，即HER2阳性且非肠型的同质亚组。
