Massicano Adriana V F, Marquez-Nostra Bernadette V, Lapi Suzanne E
1 Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
2 Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA.
Mol Imaging. 2018 Jan-Dec;17:1536012117745386. doi: 10.1177/1536012117745386.
Since its discovery, the human epidermal growth factor 2 (HER2) has been extensively studied. Presently, there are 2 standard diagnostic techniques to assess HER2 status in biopsies: immunohistochemistry and fluorescence in situ hybridization. While these techniques have played an important role in the treatment of patients with HER2-positive cancer, they both require invasive biopsies for analysis. Moreover, the expression of HER2 is heterogeneous in breast cancer and can change over the course of the disease. Thus, the degree of HER2 expression in the small sample size of biopsied tumors at the time of analysis may not represent the overall status of HER2 expression in the whole tumor and in between tumor foci in the metastatic setting as the disease progresses. Unlike biopsy, molecular imaging using probes against HER2 allows for a noninvasive, whole-body assessment of HER2 status in real time. This technique could potentially select patients who may benefit from HER2-directed therapy and offer alternative treatments to those who may not benefit. Several antibodies and small molecules against HER2 have been labeled with different radioisotopes for nuclear imaging and/or therapy. This review presents the most recent advances in HER2 targeting in nuclear medicine focusing on preclinical and clinical studies.
自发现以来，人类表皮生长因子2（HER2）已得到广泛研究。目前，有两种标准诊断技术可用于评估活检组织中的HER2状态：免疫组织化学和荧光原位杂交。虽然这些技术在HER2阳性癌症患者的治疗中发挥了重要作用，但它们都需要进行侵入性活检来进行分析。此外，HER2在乳腺癌中的表达是异质性的，并且会在疾病过程中发生变化。因此，在分析时活检肿瘤小样本中HER2的表达程度可能无法代表整个肿瘤以及转移情况下随着疾病进展肿瘤灶之间HER2表达的整体状态。与活检不同，使用针对HER2的探针进行分子成像可实现对HER2状态的无创、全身实时评估。该技术有可能筛选出可能从HER2靶向治疗中获益的患者，并为那些可能无法获益的患者提供替代治疗方案。几种针对HER2的抗体和小分子已用不同的放射性同位素进行标记，用于核成像和/或治疗。本综述介绍了核医学中HER2靶向研究的最新进展，重点关注临床前和临床研究。
