3.Association between the HER2 Gene Status and the Efficacy of First-line Pemetrexed Combined with Platinum Chemotherapy in Patients with Advanced Lung Adenocarcinoma.
Panhua LI ; Banban LI ; Yunshu SHI ; Fengming ZHANG ; Shujing SHEN ; Xingya LI
Chinese Journal of Lung Cancer 2019;22(3):137-142
BACKGROUND:
Human epidermal growth factor receptor 2 (HER2) is one of the driver genes of non-small cell lung cancer (NSCLC). Several studies have shown that the efficacy of pemetrexed in HER2-mutant NSCLC is controversial. The aim of this study is to investigate the efficacy of pemetrexed combined with platinum chemotherapy in patients with HER2-mutant and HER2 wild-type lung adenocarcinoma.
METHODS:
The clinical data of 106 cases of EGFR, ALK, ROS-1, KRAS, BRAF, RET and MET-negative patients with advanced lung adenocarcinoma patients who diagnosed by histopathology in the First Affiliated Hospital of Zhengzhou University were retrospectively reviewed. The relationships between HER2 gene status, clinical characteristics and response and progression-free survival (PFS) were analyzed.
RESULTS:
All of the 106 patients' HER2 status were determined. HER2 mutations occurred in 32 cases (30.2%), no mutations in 74 cases (69.8%). HER2 mutations were common in young, non-smoking and female patients. All patients received first-line pemetrexed and platinum-based chemotherapy. The objective response rate (ORR) and disease control rate (DCR) of patients with HER2-mutant lung adenocarcinoma were significantly higher than those without HER2 mutations (40.6% vs 14.9%, χ²=8.464, P=0.004; 93.8% vs 68.9%, χ²=6.327, P=0.012), and the difference was statistically significant. According to univariate analysis, the PFS was significantly associated with the brain metastases, maintenance chemotherapy and HER2 gene status (P<0.05), but not with age, gender, smoking history, oligometastases, liver metastases and type of platinum (P>0.05). Cox multivariate analysis indicated that HER2 mutation was an independent positive prognostic factor of PFS (P=0.038).
CONCLUSIONS
HER2-mutant lung adenocarcinoma patients with first-line pemetrexed combined with platinum chemotherapy have greater clinical benefit than HER2 wild-type patients.
Adenocarcinoma of Lung
;
drug therapy
;
genetics
;
pathology
;
Aged
;
Antineoplastic Combined Chemotherapy Protocols
;
therapeutic use
;
Disease-Free Survival
;
Female
;
Genes, erbB-2
;
genetics
;
Humans
;
Male
;
Middle Aged
;
Mutation
;
Pemetrexed
;
therapeutic use
;
Platinum
;
therapeutic use
;
Retrospective Studies
;
Treatment Outcome
4.MicroRNA-222 Expression as a Predictive Marker for Tumor Progression in Hormone Receptor-Positive Breast Cancer.
Song Hee HAN ; Hyun Jeong KIM ; Jae Moon GWAK ; Mimi KIM ; Yul Ri CHUNG ; So Yeon PARK
Journal of Breast Cancer 2017;20(1):35-44
PURPOSE: The microRNA-221/222 (miR-221/222) gene cluster has been reported to be associated with the promotion of epithelial-mesenchymal transition (EMT), downregulation of estrogen receptor-α, and tamoxifen resistance in breast cancer. We studied the expression of miR-222 in human breast cancer samples to analyze its relationship with clinicopathologic features of the tumor, including estrogen receptor status, expression of EMT markers, and clinical outcomes. METHODS: Quantitative real-time polymerase chain reaction was performed to detect the expression of miR-222 in 197 invasive breast cancers. Expression of EMT markers (vimentin, smooth muscle actin, osteonectin, N-cadherin, and E-cadherin) was evaluated using immunohistochemistry. RESULTS: High miR-222 levels were associated with high T stage, high histologic grade, high Ki-67 proliferation index, and HER2 gene amplification. Its expression was significantly higher in the luminal B and human epidermal growth factor receptor 2-positive (HER2+) subtypes than in the luminal A and triple-negative subtypes. In the hormone receptor-positive subgroup, there was a significant negative correlation between miR-222 and estrogen receptor expression, and miR-222 expression was associated with EMT marker expression. In the group as a whole, high miR-222 expression was not associated with clinical outcome. However, subgroup analyses by hormone receptor status revealed that high miR-222 expression was a poor prognostic factor in the hormone receptor-positive subgroup, but not in the hormone receptor-negative subgroup. CONCLUSION: This study showed that miR-222 is associated with down-regulation of the estrogen receptor, EMT, and tumor progression in hormone receptor-positive breast cancer, indicating that miR-222 might be associated with endocrine therapy resistance and poor clinical outcome in hormone receptor-positive breast cancer.
Actins
;
Breast Neoplasms*
;
Breast*
;
Cadherins
;
Down-Regulation
;
Epithelial-Mesenchymal Transition
;
Estrogens
;
Genes, erbB-2
;
Humans
;
Immunohistochemistry
;
Multigene Family
;
Muscle, Smooth
;
Osteonectin
;
Phenobarbital
;
Prognosis
;
Real-Time Polymerase Chain Reaction
;
Receptor, Epidermal Growth Factor
;
Tamoxifen
5.HER2 Status and Its Heterogeneity in Gastric Carcinoma of Vietnamese Patient.
Dang Anh Thu PHAN ; Vu Thien NGUYEN ; Thi Ngoc Ha HUA ; Quoc Dat NGO ; Thi Phuong Thao DOAN ; Sao Trung NGUYEN ; Anh Tu THAI ; Van Thanh NGUYEN
Journal of Pathology and Translational Medicine 2017;51(4):396-402
BACKGROUND: Human epidermal growth factor receptor 2 (HER2) is related to the pathogenesis and poor outcome of numerous types of carcinomas, including gastric carcinoma. Gastric cancer patients with HER2 positivity have become potential candidates for targeted therapy with trastuzumab. METHODS: We investigated 208 gastric cancer specimens using immunohistochemistry (IHC), fluorescence in situ hybridization and dual in situ hybridization (ISH). We also investigated the concordance between IHC and ISH. The correlation between HER2 status and various clinicopathological findings was also investigated. RESULTS: In total, 15.9% (33/208) and 24.5% (51/208) of gastric cancers showed HER2 gene amplification and protein overexpression, respectively. A high level of concordance between ISH and IHC analyses (91.3%, κ = 0.76) was found. A significant correlation between HER2 status and intestinal-type (p < .05) and differentiated carcinomas (p < .05) was also noted. The HER2 heterogeneity was high in gastric cancers; we found 68.8% phenotypic heterogeneity and 57.6% genotypic heterogeneity. Heterogeneity in HER2 protein expression and gene amplification showed a close association with diffuse histologic type and IHC 2+. CONCLUSIONS: HER2 protein overexpression and gene amplification were detected in 24.5% and 15.9% of gastric cancer specimens, respectively. Intestinal-type showed a higher level of HER2 protein overexpression and gene amplification than diffuse type. HER2 status also showed a significant relationship with well- and moderately-differentiated carcinomas. The ratio of phenotypic and genotypic heterogeneity of HER2 was high in gastric carcinomas and was associated with HER2 IHC 2+ and diffuse histologic type.
Asian Continental Ancestry Group*
;
Fluorescence
;
Gene Amplification
;
Genes, erbB-2
;
Humans
;
Immunohistochemistry
;
In Situ Hybridization
;
Population Characteristics*
;
Receptor, Epidermal Growth Factor
;
Stomach Neoplasms
;
Trastuzumab
7.Assessment of HER2 gene amplification in breast cancer: a comparison of dual-color in-situ hybridization and fluorescence in-situ hybridization.
Yan XU ; Wentao YANG ; Fei YANG ; Yongming LU ; Xu CAI ; Xiaoyan ZHOU
Chinese Journal of Pathology 2014;43(4):226-230
OBJECTIVETo compare dual-color in-situ hybridization (DISH) with fluorescence in situ hybridization(FISH) in evaluating the human HER2 gene status in invasive breast cancer.
METHODSHER2 gene status in 110 cases of breast invasive ductal carcinomas with a 2+ score on immunohistochemistry (IHC) was investigated by FISH and DISH. The 2007 and 2013 ASCO (American Society of Clinical Oncology)/CAP (College of American Pathologists) HER2 guideline were used respectively to evaluate the agreement between these two techniques.
RESULTS(1) Using the 2007 ASCO/CAP guideline, the overall concordance between FISH and DISH was 97.3% (107/110). Fifty of 51 samples with amplification by FISH were also detected by DISH and the remaining one sample was equivocal.Eight of 10 equivocal samples by FISH were equivocal by DISH and the remaining two samples were negative. Forty-nine samples with no amplification by FISH were all negative by DISH. The concordance was 98.0%, 8/10 and 100.0% respectively for the FISH positive, equivocal and negative groups. (2) Using the 2013 ASCO/CAP guideline, the overall concordance between FISH and DISH was 90.0% (99/110). Fifty-three of 55 samples with amplification by FISH were also detected by DISH and the remaining two were equivocal and negative respectively. Two of 12 equivocal samples by FISH were equivocal by DISH and the remaining ten samples were negative in 7 cases and equivocal in 3 cases. Forty-three samples with no amplification by FISH were all negative by DISH. The concordance was 96.4%, 3/12 and 100.0% respectively for the FISH positive, equivocal and negative groups. Pearson correlation analysis indicated that the HER2 status detected by FISH and DISH were significantly correlated with each other (R=0.584, P<0.01).
CONCLUSIONSThere is a high concordance between DISH and FISH for assessing the HER2 gene status in invasive breast cancer. DISH is a new option for assessing HER2 gene status of breast cancer in clinical practice. The clinical significance of the discordance between DISH and FISH in equivocal cases warrants further study.
Breast Neoplasms ; genetics ; Carcinoma, Ductal, Breast ; genetics ; Female ; Gene Amplification ; Genes, erbB-2 ; Humans ; In Situ Hybridization ; methods ; In Situ Hybridization, Fluorescence ; methods
8.To improve the quality of pathologic diagnosis through standardized HER2 testing.
Chinese Journal of Pathology 2014;43(4):217-218
Breast Neoplasms
;
diagnosis
;
genetics
;
pathology
;
Carcinoma, Ductal, Breast
;
diagnosis
;
genetics
;
pathology
;
Centromere
;
genetics
;
Chromosomes, Human, Pair 17
;
genetics
;
Early Detection of Cancer
;
methods
;
Female
;
Gene Amplification
;
Gene Dosage
;
Genes, erbB-2
;
Humans
;
Immunohistochemistry
;
In Situ Hybridization
;
standards
;
Receptor, ErbB-2
;
genetics
9.Dual-color silver-enhanced in-situ hybridization for determination of HER2 gene amplification in gastric carcinoma.
Daming FAN ; Yujun LI ; Wenwen RAN ; Wenjuan YU ; Hong LI
Chinese Journal of Pathology 2014;43(1):4-7
OBJECTIVETo investigate the concordance of dual-color silver enhanced in-situ hybridization (DSISH) and immunohistochemistry (IHC) in the detection of HER2 gene amplification and expression and to evaluate the values of DSISH in detecting HER2 gene status in gastric carcinoma.
METHODSBy using automated DSISH and IHC, HER2 gene status was detected in 230 cases of gastric cancer.
RESULTSAmong the 230 cases of gastric carcinoma tested by DSISH, 43 cases were positive and 187 cases were negative; HER2 gene amplification rate was 18.7% (43/230). The expression of HER2 protein was negative, weakly, moderately and strongly positive in 115, 69, 15 and 31 cases, respectively, by IHC. HER2 protein positive rate was 13.5% (31/230). Of the 43 HER2 gene amplification cases by DSISH, 2, 10, 2 and 29 cases were negative, weakly, moderately and strongly positive by IHC; Of the 187 HER2 negative cases by DSISH, 113, 59, 13 and 2 cases were negative, weakly, moderately and strongly positive by IHC, respectively. The overall concordance of HER2 status in the investigation between IHC and DSIDH was 93.5% (201/215), with a high consistency (Kappa coefficient 0.767, P < 0.01).
CONCLUSIONSDSISH can be applied to detect the HER2 gene status in gastric cancer and it also has a high consistency with the result of IHC. In addition, due to frequent heterogeneous expression of HER2, cases with moderate HER2 protein expression may need further assessment by DSISH.
Adult ; Aged ; Aged, 80 and over ; Esophagogastric Junction ; Female ; Gene Amplification ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; In Situ Hybridization ; methods ; In Situ Hybridization, Fluorescence ; Male ; Middle Aged ; Phosphoproteins ; genetics ; metabolism ; Polyploidy ; Receptor, ErbB-2 ; metabolism ; Silver Staining ; Stomach Neoplasms ; genetics ; metabolism
10.Detecting the spectrum of multigene mutations in non-small cell lung cancer by Snapshot assay.
Jian SU ; Xu-Chao ZHANG ; She-Juan AN ; Wen-Zhao ZHONG ; Ying HUANG ; Shi-Liang CHEN ; Hong-Hong YAN ; Zhi-Hong CHEN ; Wei-Bang GUO ; Xiao-Sui HUANG ; Yi-Long WU
Chinese Journal of Cancer 2014;33(7):346-350
As molecular targets continue to be identified and more targeted inhibitors are developed for personalized treatment of non-small cell lung cancer (NSCLC), multigene mutation determination will be needed for routine oncology practice and for clinical trials. In this study, we evaluated the sensitivity and specificity of multigene mutation testing by using the Snapshot assay in NSCLC. We retrospectively reviewed a cohort of 110 consecutive NSCLC specimens for which epidermal growth factor receptor (EGFR) mutation testing was performed between November 2011 and December 2011 using Sanger sequencing. Using the Snapshot assay, mutation statuses were detected for EGFR, Kirsten rate sarcoma viral oncogene homolog (KRAS), phosphoinositide-3-kinase catalytic alpha polypeptide (PIK3CA), v-Raf murine sarcoma viral oncogene homolog B1 (BRAF), v-ras neuroblastoma viral oncogene homolog (NRAS), dual specificity mitogen activated protein kinase kinase 1 (MEK1), phosphatase and tensin homolog (PTEN), and human epidermal growth factor receptor 2 (HER2) in patient specimens and cell line DNA. Snapshot data were compared to Sanger sequencing data. Of the 110 samples, 51 (46.4%) harbored at least one mutation. The mutation frequency in adenocarcinoma specimens was 55.6%, and the frequencies of EGFR, KRAS, PIK3CA, PTEN, and MEK1 mutations were 35.5%, 9.1%, 3.6%, 0.9%, and 0.9%, respectively. No mutation was found in the HER2, NRAS, or BRAF genes. Three of the 51 mutant samples harbored double mutations: two PIK3CA mutations coexisted with KRAS or EGFR mutations, and another KRAS mutation coexisted with a PTEN mutation. Among the 110 samples, 47 were surgical specimens, 60 were biopsy specimens, and 3 were cytological specimens; the corresponding mutation frequencies were 51.1%, 41.7%, and 66.7%, respectively (P = 0.532). Compared to Sanger sequencing, Snapshot specificity was 98.4% and sensitivity was 100% (positive predictive value, 97.9%; negative predictive value, 100%). The Snapshot assay is a sensitive and easily customized assay for multigene mutation testing in clinical practice.
Adenocarcinoma
;
genetics
;
Carcinoma, Non-Small-Cell Lung
;
genetics
;
Class I Phosphatidylinositol 3-Kinases
;
Genes, erbB-1
;
Genes, erbB-2
;
Genes, ras
;
Humans
;
Mutation
;
PTEN Phosphohydrolase
;
Phosphatidylinositol 3-Kinases
;
Proto-Oncogene Proteins
;
Proto-Oncogene Proteins B-raf
;
Proto-Oncogene Proteins p21(ras)
;
Retrospective Studies
;
ras Proteins

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