胃癌术前化疗后HER2表达及扩增状态的变化
Changes in HER2 Expression and Amplification Status Following Preoperative Chemotherapy for Gastric Cancer.
作者信息
Shu Sei, Iimori Makoto, Nakanishi Ryota, Jogo Tomoko, Saeki Hiroshi, Oki Eiji, Maehara Yoshihiko
机构信息
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Kyushu University, Fukuoka, Japan.
Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Japan.
出版信息
In Vivo. 2018 Nov-Dec;32(6):1491-1498. doi: 10.21873/invivo.11405.
BACKGROUND
It is essential to establish a strategy for second-line treatment for human epidermal growth factor receptor 2 (HER2)-positive gastric cancer; however, HER2 expression status after chemotherapy treatment is not routinely determined.
MATERIALS AND METHODS
We analyzed 25 cases of gastric cancer that received preoperative chemotherapy and selected the six pre-treatment samples that were HER2-positive. Pre- and post-treatment tumor samples were examined for HER2 expression, and for HER2, epidermal growth factor receptor (EGFR), and hepatocyte growth factor receptor (MET) gene amplification.
RESULTS
Three patients had been treated with trastuzumab plus chemotherapy, and three patients with cytotoxic chemotherapy alone. Only one case that had an initial HER2 score of 3+ and had received trastuzumab plus chemotherapy remained HER2-positive after treatment. Decrease or loss of HER2 expression and amplification was observed in the other five patients. Amplification of EGFR or MET was not observed in any pre- or post-treatment specimens.
CONCLUSION
Our data suggest that trastuzumab plus chemotherapy or chemotherapy alone may induce loss of HER2 positivity.
背景
建立人表皮生长因子受体2（HER2）阳性胃癌的二线治疗策略至关重要；然而，化疗后HER2表达状态并非常规检测项目。
材料与方法
我们分析了25例接受术前化疗的胃癌病例，并选取了6例治疗前HER2阳性的样本。对治疗前和治疗后的肿瘤样本进行HER2表达检测，以及HER2、表皮生长因子受体（EGFR）和肝细胞生长因子受体（MET）基因扩增检测。
结果
3例患者接受了曲妥珠单抗联合化疗，3例患者仅接受了细胞毒性化疗。仅有1例初始HER2评分为3+且接受曲妥珠单抗联合化疗的患者在治疗后仍为HER2阳性。其他5例患者观察到HER2表达和扩增减少或缺失。在任何治疗前或治疗后的标本中均未观察到EGFR或MET扩增。
结论
我们的数据表明，曲妥珠单抗联合化疗或单纯化疗可能导致HER2阳性丧失。
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