Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, United States.
Sarah Cannon Research Institute, Nashville, TN, United States.
Cancer Treat Rev. 2021 Nov;100:102286. doi: 10.1016/j.ctrv.2021.102286. Epub 2021 Sep 2.
The identification of Human epidermal growth factor receptor 2 (HER2) as a target in breast cancer and the subsequent development of HER2-targeted therapies has revolutionized the treatment of patients with HER2-positive breast cancer. However, there is an increasing awareness of how frequently tumors have low or heterogeneous expression of HER2. It is now recognized that this impacts the degree of benefit from HER2-targeted therapies. With the advent of novel and more potent antibody drug conjugates, targeting HER2 in traditional HER2-negative tumors with "HER2-low" expression is becoming possible. It is essential to refine the nomenclature around HER2 expression to enable clinicians to optimize treatment for patients across the HER2 expression spectrum in breast cancer. HER2 heterogeneity can be detected by conventional IHC, gene expression profiling or other methods and numerous studies have documented the correlation between the presence of HER2 heterogeneity and shorter disease-free survival (DFS) and overall survival (OS). Validation of techniques to identify HER2 heterogeneity in the clinic and concurrent development of agents to effectively treat tumors with non-uniform HER2 expression is needed.
人表皮生长因子受体 2（HER2）作为乳腺癌的靶点被鉴定出来，随后开发了针对 HER2 的治疗方法，这彻底改变了 HER2 阳性乳腺癌患者的治疗方法。然而，人们越来越意识到肿瘤中 HER2 的表达水平低或异质性的频率有多高。现在已经认识到，这会影响到从 HER2 靶向治疗中获益的程度。随着新型、更有效的抗体药物偶联物的出现，针对具有“HER2 低表达”的传统 HER2 阴性肿瘤中的 HER2 进行靶向治疗成为可能。完善 HER2 表达相关的命名法对于使临床医生能够在乳腺癌的 HER2 表达谱范围内为患者优化治疗至关重要。HER2 异质性可以通过常规免疫组化、基因表达谱分析或其他方法检测，许多研究都记录了 HER2 异质性的存在与无病生存期（DFS）和总生存期（OS）较短之间的相关性。需要验证在临床上识别 HER2 异质性的技术，并同时开发有效治疗 HER2 表达不均匀的肿瘤的药物。
