Think "HER2" different: integrative diagnostic approaches for HER2-low breast cancer.

IF 4.4 Q1 PATHOLOGY PATHOLOGICA Pub Date : 2023-12-01 DOI:10.32074/1591-951X-942
Caterina Marchiò, Carmen Criscitiello, Cristian Scatena, Alfredo Santinelli, Paolo Graziano, Umberto Malapelle, Giulia Cursano, Konstantinos Venetis, Giuseppe Nicolò Fanelli, Francesco Pepe, Enrico Berrino, Carmine De Angelis, Giuseppe Perrone, Giuseppe Curigliano, Nicola Fusco
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Abstract

This work explores the complex field of HER2 testing in the HER2-low breast cancer era, with a focus on methodological aspects. We aim to propose clear positions to scientific societies, institutions, pathologists, and oncologists to guide and shape the appropriate diagnostic strategies for HER2-low breast cancer. The fundamental question at hand is whether the necessary tools to effectively translate our knowledge about HER2 into practical diagnostic schemes for the lower spectrum of expression are available. Our investigation is centered on the significance of distinguishing between an immunohistochemistry (IHC) score 0 and score 1+ in light of the clinical implications now apparent, as patients with HER2-low breast cancer become eligible for trastuzumab-deruxtecan treatment. Furthermore, we discuss the definition of HER2-low beyond its conventional boundaries and assess the reliability of established diagnostic procedures designed at a time when therapeutic perspectives were non-existent for these cases. In this regard, we examine potential complementary technologies, such as gene expression analysis and liquid biopsy. Ultimately, we consider the potential role of artificial intelligence (AI) in the field of digital pathology and its integration into HER2 testing, with a particular emphasis on its application in the context of HER2-low breast cancer.

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与众不同的 "HER2 "思维:针对 HER2 低乳腺癌的综合诊断方法。
这项工作探讨了在 HER2 低乳腺癌时代进行 HER2 检测的复杂领域,重点关注方法学方面。我们的目标是向科学协会、机构、病理学家和肿瘤学家提出明确的立场,以指导和制定适当的 HER2 低乳腺癌诊断策略。目前的根本问题是,是否有必要的工具来有效地将我们对 HER2 的了解转化为针对低表达谱的实用诊断方案。由于 HER2 低表达乳腺癌患者有资格接受曲妥珠单抗-德鲁司康治疗,我们的研究重点是区分免疫组化(IHC)0 分和 1+ 分的意义,因为这对临床的影响是显而易见的。此外,我们还讨论了超越传统界限的 HER2 低分值的定义,并评估了在对这些病例尚无治疗前景时设计的既定诊断程序的可靠性。在这方面,我们研究了潜在的补充技术,如基因表达分析和液体活检。最后,我们考虑了人工智能(AI)在数字病理学领域的潜在作用及其与 HER2 检测的整合,并特别强调了其在 HER2 低乳腺癌中的应用。
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来源期刊
PATHOLOGICA
PATHOLOGICA PATHOLOGY-
CiteScore
5.90
自引率
5.70%
发文量
108
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