Clinical significance of assessing Her2/neu expression in gastric cancer with dual tumor tissue paraffin blocks

Ge, Xiaowen; Wang, Shuangfeng; Zeng, Hai‐Ying; Jin, Xuejuan; Sujie, Akesu; Xu, Chen; Huang, Jie; Ji, Yuan; Tan, Yaohong; Liu, Tianshu; Hou, Yayi; Qin, Jing; Sun, Yihong; Qin, Xin-yu

doi:10.1016/j.humpath.2015.02.011

Cited by 27 publications

(32 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Haematoxylin and eosin (H&E) staining was routinely performed. An HER2 (4B5) rabbit monoclonal antibody (Ventana Medical Systems, Tucson, AZ, USA) was used, and immunohistochemical staining was performed with iView DAB Detection Kits (Ventana Medical Systems) on BenchMark XT automated stainers (Ventana Medical Systems), following previously described procedures …”

Section: Methodsmentioning

confidence: 99%

HER2 assessment in locally advanced gastric cancer: comparing the results obtained with the use of two primary tumour blocks versus those obtained with the use of all primary tumour blocks

Jiang

et al. 2017

Histopathology

Self Cite

View full text Add to dashboard Cite

Aims: HER2 is currently the only biomarker used to select eligible patients with advanced gastric cancer (GC) for targeted therapy. The aims of this study were to verify the value of dual-block HER2 assessment and to explore whether increasing the block number is more beneficial by carrying out a randomized prospective cohort study in which dual-block and all-block HER2 assessment were compared in resected specimens of GC. Methods and results: Five hundred and forty-nine resected GC specimens were randomly enrolled into two cohorts: a dual-block group (n = 274) with two primary tumour blocks tested, and an all-block group (n = 275) with all primary tumour blocks tested. Immunohistochemical staining of HER2 was performed. For HER2-equivocal (2+) cases, fluorescence in-situ hybridization (FISH) was performed. As compared with single-block assessment, dual-block assessment increased the HER2 immunohistochemistry (IHC)-positive (3+) rate. The rate with dual-block assessment (11.3%) was significantly higher than that with block 1 assessment (8.8%) (P = 0.016) and block 2 assessment (9.1%) (P = 0.031). Similarly, all-block assessment demonstrated a higher HER2 3+ rate (12.4%) than single-block assessment (block 1, 6.5%; block 2, 6.2%; block 3, 7.2%; block 4, 8.7%) (P < 0.05). HER2 3+ rates of all-block and dualblock assessments showed no significant difference (P = 0.703). After IHC and FISH results had been combined, the HER2-positive rate with all-block assessment (13.5%) was slightly higher than that with dual-block assessment (12.0%), although the difference was not statistically significant (P = 0.62). Conclusions: Dual-block immunohistochemical assessment is an effective, practical and economic approach that is suitable for the preliminary screening of HER2. We recommend that dual-block HER2 assessment be routinely performed on resected specimens of GC. All-block assessment can be a supplement to dual-block assessment if necessary.

show abstract

Section: Methodsmentioning

confidence: 99%

HER2 assessment in locally advanced gastric cancer: comparing the results obtained with the use of two primary tumour blocks versus those obtained with the use of all primary tumour blocks

Jiang

et al. 2017

Histopathology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Another interesting problem is that of sampling errors, as HER2 expression evaluated in a portion of the tumour might not be representative of the HER2 status in the whole tumour. On this point, several authors have shown that the analysis of more than 1 tumour section increases the HER2-positive detection rate by 5-10% [111,117,131,132]. With regard to HER2 status in matched biopsy and resection specimens, various authors reported a high concordance rate, ranging from 74 to 96% [111,113,115,116,133,134].…”

Section: Adding Further Complexity: Ithmentioning

confidence: 99%

Heterogeneity in Gastric Cancer: From Pure Morphology to Molecular Classifications

Gullo

Carneiro²,

Oliveira³

et al. 2017

Pathobiology

112

103

View full text Add to dashboard Cite

Gastric cancer (GC) represents a global health concern. Despite advances in prevention, diagnosis, and therapy, GC is still the third leading cause of cancer mortality worldwide, with more than 720,000 estimated deaths in 2012. Overall survival for advanced disease is about 1 year, a dismal prognosis that is partly due to the high levels of biological heterogeneity found in GC. Indeed, GC is a highly heterogeneous disease from morphological and molecular standpoints. The numerous histological and molecular classifications currently available reflect such heterogeneity. Although recent high-throughput studies cluster the molecular data obtained into subgroups with clinical relevance, we still need a practical, prognostic, and predictive classification system, integrating morphological and molecular features, towards the identification of novel therapeutic targets. It is noteworthy that GC heterogeneity encompasses not only interpatient variability (intertumour heterogeneity), but also variations within the same tumour (intratumour heterogeneity). The latter encompasses spatial heterogeneity (in different tumour areas) and temporal heterogeneity (along progression from primary to recurrent and/or metastatic disease). In this review, we analyse the morphological, immunophenotypic, and molecular heterogeneity in GC as the basis for a better understanding of the disease, and discuss the practical implications for diagnostic pathology, prognostic evaluation, and precision therapy.

show abstract

“…HER2 staining was performed with an iView DAB Detection Kit (Ventana, Tucson, AZ) on a BenchMark XT automated stainer (Ventana Medical Systems, Inc.,Tucson, AZ) according to the procedures previously described [36]. HER2 (4B5) rabbit monoclonal antibody (Ventana Medical Systems, Inc., Tucson, AZ) was used.…”

Section: Methodsmentioning

confidence: 99%

Poor efficacy response to trastuzumab therapy in advanced gastric cancer with homogeneous HER2 positive and non-intestinal type

Jiang

et al. 2017

Oncotarget

Self Cite

View full text Add to dashboard Cite

IntroductionFactors affecting trastuzumab efficacy in advanced gastric cancer (GC) are largely unknown. Heterogeneity is a notable feature of HER2 in GC. Whether the heterogeneity influences trastuzumab efficacy is still unknown.ResultsThe HER2homogeneous group and HER2heterogeneous group showed no statistical difference in RR (46.4% vs 55.0%, P = 0.558), PFS (5.80 vs 6.30 months, P = 0.804) and OS (16.00 vs 16.00 months, P = 0.787). The Laurenintestinal group and Laurennon-intestinal group demonstrated no discrepancy in PFS (6.00 vs 6.00 months, P = 0.912) and OS (16.50 vs 14.00 months, P = 0.227). However, by combining HER2 heterogeneity and Lauren classification, PFS and OS of HER2homogeneous/Laurennon-intestinal subgroup was the shortest among the 4 subgroups (P = 0.012 and P = 0.037), which was much shorter than the other patients (PFS:3.00 vs 6.30 months, P = 0.003; OS: 4.50 vs 16.50 months, P = 0.004). Univariate and multivariate analysis showed that HER2 heterogeneity combined with Lauren classification was an independent prognostic factor in both PFS (P = 0.031 and P = 0.002) and OS (P = 0.039 and P = 0.013).Materials and Methods48 patients with HER2 positive advanced GCs accepting trastuzumab treatment were retrospectively analyzed. Based on HER2 heterogeneity, the patients were divided into a HER2homogeneous group and a HER2heterogeneous group. Response rate (RR), progression free survival (PFS), and overall survival (OS) were compared. Main clinicopathological factors including Lauren classification were subjected to subgroup analysis.ConclusionsHER2 heterogeneity alone may not correlate with trastuzumab efficacy in HER2 positive advanced GCs. HER2 heterogeneity combined with Lauren classification may help to identify a subgroup with poor response to trastuzumab which is homogeneous HER2 positive and non-intestinal type.

show abstract

Clinical significance of assessing Her2/neu expression in gastric cancer with dual tumor tissue paraffin blocks

Cited by 27 publications

References 30 publications

HER2 assessment in locally advanced gastric cancer: comparing the results obtained with the use of two primary tumour blocks versus those obtained with the use of all primary tumour blocks

HER2 assessment in locally advanced gastric cancer: comparing the results obtained with the use of two primary tumour blocks versus those obtained with the use of all primary tumour blocks

Heterogeneity in Gastric Cancer: From Pure Morphology to Molecular Classifications

Poor efficacy response to trastuzumab therapy in advanced gastric cancer with homogeneous HER2 positive and non-intestinal type

Contact Info

Product

Resources

About