Prognostic and clinical significance of HER-2 low expression in early-stage gastric cancer

Yang, Tao; Xu, Rui; You, Jie; Li, Fang; Yan, Bing; Cheng, Jianan

doi:10.1186/s12885-022-10262-7

Cited by 12 publications

(5 citation statements)

References 36 publications

(46 reference statements)

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“…However, its influence on prognosis remains controversial. Yang et al [ 32 ] suggested that low expression of HER2 might lead to distinct biological characteristics but was not an independent prognostic factor for early-stage gastric cancer’s disease-free survival (DFS) or OS. Jiang et al [ 33 ] demonstrated that the co-expression of Sp1 and HER-2 was associated with poor prognosis in gastric cancer patients.…”

Section: Discussionmentioning

confidence: 99%

A novel immunohistochemical score predicts the postoperative prognosis of gastric cancer patients

Liu

Wang

et al. 2023

World J Surg Onc

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Background and aim Immunohistochemistry indicators are increasingly being used to predict the survival prognosis of cancer patients after surgery. This study aimed to combine some markers to establish an immunohistochemical score (MSI-P53-Ki-67[MPK]) and stratify postoperative patients with gastric cancer according to the score. Methods We used 245 patients who underwent surgery at one center as the training cohort and 111 patients from another center as the validation cohort. All patients were treated between January 2012 and June 2018. The training cohort was screened for prognostic factors, and MPK scores were established using univariate and multifactorial COX risk proportional models. Patients were prognostically stratified according to the MPK score after gastrectomy for gastric cancer. Overall survival (OS) and recurrence-free survival (RFS) rates were compared among low-, intermediate-, and high-risk groups using the Kaplan–Meier method, and survival curves were plotted. Finally, the MPK score was validated using the validation cohort. Results In the training group, there were statistically significant differences in OS and RFS in the low, medium, and high-risk groups (P < 0.001). Thirty patients were in the high-risk group (12.2%). The median survival times of the three groups were 64.0, 44.0, and 23.0, respectively, and median times to recurrence were 54.0, 35.0, and 16.0 months, respectively. In the validation group, the prognosis in the three risk groups remained significantly different (P < 0.001). Conclusions The novel MPK score could effectively predict the postoperative OS and RFS of gastric cancer patients, risk-stratify postoperative patients, and identify postoperative high-risk patients for refined management.

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Section: Discussionmentioning

confidence: 99%

A novel immunohistochemical score predicts the postoperative prognosis of gastric cancer patients

Liu

Wang

et al. 2023

World J Surg Onc

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“…Trastuzumab in combination with chemotherapy and trastuzumab deruxtecan in tumors with HER2 high expression demonstrated a significant overall survival improvement compared with the group administered only chemotherapy, as the development of companion diagnosis and molecular-targeting therapeutic agents has progressed in recent years [ 13 , 14 ]. Furthermore, trastuzumab deruxtecan has been recently revealed to show clinical activity even in GC with low HER2 expression, and the importance of more accurate HER2 expression evaluation is increasing [ 31 ]. In the present study, we demonstrated that the time to specimen processing, the intestinal type of cancers and pM are independent factors involving HER2-positivity.…”

Section: Discussionmentioning

confidence: 99%

The effect of specimen processing time on HER2 expression in gastric cancer and esophagogastric junction cancer: a single-center retrospective observational study

et al. 2023

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Background Recent developments in the field of companion diagnosis and molecular-targeting therapeutic agents have helped in developing treatments targeting human epidermal growth factor receptor 2 (HER2) in gastric cancer (GC) and esophagogastric junction cancer (EGJC), and the importance of accurate diagnosis of HER2 expression is increasing. However, the HER2-positivity rate significantly differs among reports in GC and EGJC, and factors that affect HER2-positivity require elucidation. Methods The present study retrospectively examined factors related to HER2-positivity in a single institution, including age, sex, body mass index, the American Society of Anesthesiologists physical status, tumor information, and surgery information, including time to specimen processing. Results Our study included 165 patients tested for HER2 using GC and EGJC surgery specimens among the 1,320 patients who underwent gastrectomy from January 2007 to June 2022. In total, 35 (21.2%) and 130 (78.8%) patients were HER2-positive and -negative, respectively. Multivariate analysis revealed that intestinal type (odds ratio [OR]: 3.41, 95% confidence interval [CI]: 1.44–8.09, p = 0.005), pM1 (OR: 3.99, 95% CI: 1.51–10.55, p = 0.005), and time to specimen processing of < 120 min (OR: 2.65, 95% CI: 1.01–6.98, p = 0.049) were independent factors that affected HER2-positivity. Conclusions The outcomes of the present study indicated that intestinal type, pM, and time to specimen processing are important factors affecting HER2-positive rates in GC and EGJC. Therefore, the risk of false-negative HER2 results may be reduced by decreasing the time required to process the resected specimen. Additionally, accurate diagnosis of HER2 expression may increase the opportunity to administer molecular-targeted drugs that can expect therapeutic effects to patients appropriately. Trail registration Retrospectively registered.

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“…While the evaluation of human epidermal growth factor receptor 2 (Her2) has been routinely performed in patients with gastroesophageal AC for years and is a feasible surrogate parameter for the response to Her2 blockage in advanced settings [ 8 ], the role of Her2 and especially Her2-low expression in localized settings is still evaluated [ 9 ]. Although patient selection for targeted treatment still poses an issue for clinical trials, the analysis of Her2 expression remains robust [ 10 ].…”

Section: Molecular Markersmentioning

confidence: 99%

Recent Advances in the Systemic Treatment of Localized Gastroesophageal Cancer

Puhr

Reiter

Preusser

et al. 2023

Cancers

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The overall survival expectancy of localized gastroesophageal cancer patients still remains under 5 years despite advances in neoadjuvant and adjuvant treatment strategies in recent years. For almost a decade, immunotherapy has been successfully implemented as a first-line treatment for various oncological diseases in advanced stages. In the case of advanced gastroesophageal cancer, 2021 witnessed several approvals of immune checkpoint inhibitor therapies by different authorities. Although it is still a debate whether this treatment should be restricted to a certain subgroup of patients based on biomarker selection, immunotherapy agents are making remarkable steps in resectable settings as well. The Checkmate-577 study demonstrated significant benefits of nivolumab as an adjuvant treatment for resectable esophageal and gastroesophageal junction tumors and thereby obtained approvals both from U.S. American and European authorities. First results of further potential practice-changing clinical trials are expected in 2023, which might change the treatment armamentarium for resectable gastroesophageal cancers significantly. This review aims to demonstrate the advances of immunotherapy and targeted therapies in treatment of localized gastric, gastroesophageal junction and esophageal tumors and gives a short summary on promising ongoing clinical trials.

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Prognostic and clinical significance of HER-2 low expression in early-stage gastric cancer

Cited by 12 publications

References 36 publications

A novel immunohistochemical score predicts the postoperative prognosis of gastric cancer patients

A novel immunohistochemical score predicts the postoperative prognosis of gastric cancer patients

The effect of specimen processing time on HER2 expression in gastric cancer and esophagogastric junction cancer: a single-center retrospective observational study

Recent Advances in the Systemic Treatment of Localized Gastroesophageal Cancer

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