低 HER2 乳腺癌:解读免疫组化的挑战。

Noel Chia, Mihir Ananta Gudi, Emad Rakha, Puay Hoon Tan
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引用次数: 0

摘要

摘要:人表皮生长因子受体 2(HER2)蛋白在乳腺癌中的过度表达对预后和治疗具有重要影响。抗 HER2 阻断剂已被证明是治疗 HER2 阳性肿瘤手术的有效辅助手段。迄今为止,HER2 免疫组化(IHC)和原位杂交(ISH)评分算法主要用于识别 HER2 阳性病例。最近发表的一项 III 期临床试验(DESTINY-Breast04)表明,对于 IHC 评分为 1+ 或 2+、无 ISH 扩增的转移性疾病患者,抗体药物共轭物(曲妥珠单抗-德鲁司坦)可显著减少疾病进展和死亡,从而定义了一类新的 HER2 低病例。目前,IHC评分为0、1+和2+的病例在观察者之间存在很大的差异,用目前的算法识别HER2低的乳腺癌可能会带来很大的挑战。要更好地定义 HER2 低乳腺癌、锁定合适的患者群体并评估治疗效果,还需要在这一领域开展更多的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HER2-low breast cancers: challenges in the interpretation of immunohistochemistry.

Abstract: Overexpression of human epidermal growth factor receptor 2 (HER2) protein in breast cancers carries significant prognostic and therapeutic implications. Anti-HER2 blockade has shown to be a useful adjunct to surgery in treating HER2-positive tumours. Up till today, the HER2 immunohistochemistry (IHC) and in situ hybridisation (ISH) scoring algorithms are geared towards identifying HER2-positive cases. A recently published Phase III clinical trial (DESTINY-Breast04) has demonstrated that an antibody-drug conjugate (trastuzumab-deruxtecan) significantly reduced disease progression and death in patients with metastatic disease with IHC score 1+ or 2+ and without ISH amplification, defining a new category of cases known as HER2 low. At present, IHC scores 0, 1+ and 2+ show significant interobserver variability, and identifying HER2-low breast cancers may pose significant challenges with the current algorithms. More work is needed in this area to better define HER2-low breast cancers, target the appropriate group of patients and assess treatment efficacy.

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