Selecting patients with HER2-low breast cancer: Getting out of the tangle
Journal Title
European Journal of Cancer
Publication Type
Review
Abstract
The promising effect of antibody-drug conjugates on breast cancer with low expression of HER2 (HER2-low) raises many questions regarding the optimal selection of patients for this treatment. A key question is whether HER2 immunohistochemistry, an assay optimised to detect HER2 amplification, is reliable enough to assess HER2 protein levels to select patients with HER2-low breast cancer in daily pathology practices worldwide. Moreover, whether this assessment can be performed with sufficient reproducibility between pathologists in daily practices is debatable. Herein, we address the historical track record of the CAP-ASCO HER2 Guidelines, the reported limited reproducibility by pathologists of HER2 immunohistochemistry in the non-amplified cases, and the performance variation of different antibodies. Based on this summary, we propose solutions to improve the robustness to enable reliable identification of patients with HER2-low breast cancer.
Keywords
*Breast Neoplasms/pathology; Female; Humans; *Immunoconjugates/therapeutic use; In Situ Hybridization, Fluorescence; Patient Selection; Receptor, ErbB-2/metabolism; Reproducibility of Results; Biomarker; Breast cancer; HER2-low; Immunohistochemistry; Trastuzumab-deruxtecan
Department(s)
Laboratory Research
PubMed ID
36137393
Open Access at Publisher's Site
https://doi.org/10.1016/j.ejca.2022.08.022
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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