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HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma

Despite ongoing advances in the treatment of gastroesophageal cancer, prognosis remains poor. The best promise to improve this poor survival is provided by new targeted agents. Of these, human epidermal growth factor receptor 2 (HER2) is currently in the spotlight. In this review, we provide an over...

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Autores principales: Moelans, Cathy B., van Diest, Paul J., Milne, Anya N. A., Offerhaus, G. Johan A.
Formato: Texto
Lenguaje:English
Publicado: SAGE-Hindawi Access to Research 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005843/
https://www.ncbi.nlm.nih.gov/pubmed/21188213
http://dx.doi.org/10.4061/2011/674182
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author Moelans, Cathy B.
van Diest, Paul J.
Milne, Anya N. A.
Offerhaus, G. Johan A.
author_facet Moelans, Cathy B.
van Diest, Paul J.
Milne, Anya N. A.
Offerhaus, G. Johan A.
author_sort Moelans, Cathy B.
collection PubMed
description Despite ongoing advances in the treatment of gastroesophageal cancer, prognosis remains poor. The best promise to improve this poor survival is provided by new targeted agents. Of these, human epidermal growth factor receptor 2 (HER2) is currently in the spotlight. In this review, we provide an overview of recent developments in HER2 testing and results of clinical trials targeting HER2 in gastroesophageal adenocarcinoma. Based on the encouraging ToGA trial findings it is now expected that routine HER2 testing will be included in the diagnostic work-up of patients with advanced gastric cancer. With regard to this testing, overexpression of the HER2 protein seems to possess the best predictive properties. However, HER2 immunohistochemistry (IHC) is subject to assay and interobserver variability, so standardization and internal and external proficiency testing is an absolute prerequisite, especially as the IHC scoring system in gastric cancer is different from that of breast cancer. Further study is needed to investigate the clinical meaning of the significant heterogeneity observed in both gene amplification and protein overexpression in gastroesophageal cancer. Highly effective therapies for gastroesophageal cancer can only be accomplished by a multi-targeted approach, considering crosstalk between pathways and continuing to optimize chemotherapy.
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spelling pubmed-30058432010-12-23 HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma Moelans, Cathy B. van Diest, Paul J. Milne, Anya N. A. Offerhaus, G. Johan A. Patholog Res Int Review Article Despite ongoing advances in the treatment of gastroesophageal cancer, prognosis remains poor. The best promise to improve this poor survival is provided by new targeted agents. Of these, human epidermal growth factor receptor 2 (HER2) is currently in the spotlight. In this review, we provide an overview of recent developments in HER2 testing and results of clinical trials targeting HER2 in gastroesophageal adenocarcinoma. Based on the encouraging ToGA trial findings it is now expected that routine HER2 testing will be included in the diagnostic work-up of patients with advanced gastric cancer. With regard to this testing, overexpression of the HER2 protein seems to possess the best predictive properties. However, HER2 immunohistochemistry (IHC) is subject to assay and interobserver variability, so standardization and internal and external proficiency testing is an absolute prerequisite, especially as the IHC scoring system in gastric cancer is different from that of breast cancer. Further study is needed to investigate the clinical meaning of the significant heterogeneity observed in both gene amplification and protein overexpression in gastroesophageal cancer. Highly effective therapies for gastroesophageal cancer can only be accomplished by a multi-targeted approach, considering crosstalk between pathways and continuing to optimize chemotherapy. SAGE-Hindawi Access to Research 2010-12-06 /pmc/articles/PMC3005843/ /pubmed/21188213 http://dx.doi.org/10.4061/2011/674182 Text en Copyright © 2011 Cathy B. Moelans et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Moelans, Cathy B.
van Diest, Paul J.
Milne, Anya N. A.
Offerhaus, G. Johan A.
HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma
title HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma
title_full HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma
title_fullStr HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma
title_full_unstemmed HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma
title_short HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma
title_sort her-2/neu testing and therapy in gastroesophageal adenocarcinoma
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005843/
https://www.ncbi.nlm.nih.gov/pubmed/21188213
http://dx.doi.org/10.4061/2011/674182
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