Bornstein-Quevedo Leticia, de Anda-González Jazmín, Lara-Torres Cesar Octavio, Flores-Gutiérrez Juan Pablo, Dorantes-Heredia Rita, Bautista-Piña Verónica, Zaragoza-Vargas Perla, Alcaraz-Wong Aldo, Soto-Sañudo Ana Karen, Mendoza-Ramírez Saulo, Salamanca-García Moisés, Loyola-Rodríguez Georgina, Gómez-Macías Gabriela Sofia, Murguia-Perez Mario, De Luna-Sánchez Marcela, Villalobos-Valencia Ricardo, Talamantes Enrique, Arce-Salinas Claudia
Department of Immunohistochemistry and Molecular Pathology, InmunoQ, Mexico City 03200, Mexico.
Department of Pathology, Hospital de Oncología CMN Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico.
J Pers Med. 2024 Apr 28;14(5):467. doi: 10.3390/jpm14050467.
The article discusses the importance of accurately distinguishing HER2-low from HER2-negative breast cancer, as novel ADCs have demonstrated activity in a large population of patients with HER2-low-expressing BC. While current guidelines recommend a dichotomous classification of HER2 as either positive or negative, the emergence of the HER2-low concept calls for standardization of HER2 testing in breast cancer, using currently available assays to better discriminate HER2 levels. This review covers the evolution and latest updates of the ASCO/CAP guidelines relevant to this important biomarker in breast cancer, including still-evolving concepts such as HER2 low, HER2 heterogeneity, and HER2 evolution. Our group presents the latest Mexican recommendations for HER2 status evaluation in breast cancer, considering the ASCO/CAP guidelines and introducing the HER2-low concept. In the era of personalized medicine, accurate HER2 status assessment remains one of the most important biomarkers in breast cancer, and the commitment of Mexican pathologists to theragnostic biomarker quality is crucial for providing the most efficient care in oncology.
本文讨论了准确区分HER2低表达与HER2阴性乳腺癌的重要性，因为新型抗体偶联药物（ADC）已在大量HER2低表达乳腺癌患者中显示出活性。虽然当前指南建议将HER2分为阳性或阴性的二分法分类，但HER2低表达概念的出现要求在乳腺癌中对HER2检测进行标准化，使用现有的检测方法以更好地区分HER2水平。本综述涵盖了与乳腺癌这一重要生物标志物相关的美国临床肿瘤学会（ASCO）/美国病理学家协会（CAP）指南的演变和最新更新，包括仍在不断发展的概念，如HER2低表达、HER2异质性和HER2演变。我们的团队提出了墨西哥关于乳腺癌HER2状态评估的最新建议，参考了ASCO/CAP指南并引入了HER2低表达概念。在精准医疗时代，准确的HER2状态评估仍然是乳腺癌最重要的生物标志物之一，墨西哥病理学家对治疗诊断生物标志物质量的承诺对于在肿瘤学中提供最有效的治疗至关重要。
