Verschoor Noortje, Deger Teoman, Jager Agnes, Sleijfer Stefan, Wilting Saskia M, Martens John W M
Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Cancer Treat Rev. 2022 May;106:102384. doi: 10.1016/j.ctrv.2022.102384. Epub 2022 Mar 29.
Addition of HER2-targeted treatment in breast cancer is mainly determined by the HER2-receptor status of primary breast cancer tissue, since longitudinal sampling is burdensome and often not feasible. However, tumor heterogeneity and receptor conversion occur and may lead to improper diagnose as disease progresses. It is however possible that patients with their applied receptor status misjudged may benefit from HER2-targeted therapy. Liquid biopsies provide a useful source of information for receptor status and determine prognosis or evaluate therapy effectiveness. In this review, we give a comprehensive overview of current analytical and clinical validity and clinical utility of liquid biopsies for HER2 assessment. We systematically searched publications in Cochrane, Embase, PubMed and Google Scholar databases until April 2021 reporting on HER2-positivity in liquid biopsies and its concordance with tumor tissue, or on prognostic and/or predictive value of HER2-positivity in liquid biopsies. Applying our selection criteria, we identified 57 studies; 43 studies on circulating tumor cells, 13 studies on circulating tumor DNA and 1 study on extracellular vesicles. Most studies showed an association with outcome or treatment response, but used methods differed greatly, lacked a gold standard and evaluated patient groups differently hampering interpretation of results. We conclude that well-designed studies to determine assay validity and clinical validity and utility of HER2 assessment through liquid biopsies are currently lacking.
在乳腺癌中添加HER2靶向治疗主要取决于原发性乳腺癌组织的HER2受体状态，因为纵向取样负担沉重且往往不可行。然而，肿瘤异质性和受体转换会发生，并且可能随着疾病进展导致诊断不当。然而，应用的受体状态被误判的患者有可能从HER2靶向治疗中获益。液体活检为受体状态提供了有用的信息来源，并可确定预后或评估治疗效果。在本综述中，我们全面概述了液体活检用于HER2评估的当前分析和临床有效性及临床实用性。我们系统检索了Cochrane、Embase、PubMed和谷歌学术数据库中截至2021年4月的出版物，这些出版物报道了液体活检中HER2阳性及其与肿瘤组织的一致性，或液体活检中HER2阳性的预后和/或预测价值。应用我们的选择标准，我们确定了57项研究；43项关于循环肿瘤细胞的研究，13项关于循环肿瘤DNA的研究和1项关于细胞外囊泡的研究。大多数研究显示与结局或治疗反应有关，但使用的方法差异很大，缺乏金标准，且对患者群体的评估不同，这妨碍了结果的解释。我们得出结论，目前缺乏设计良好的研究来确定通过液体活检进行HER2评估的分析有效性、临床有效性及实用性。
