Pub Date : 2022-01-19DOI: 10.26420/gastrointestcancerresther.2022.1034
Hsueeh Cf, Tsung Sh
Background: The efficacy of the trastuzumab therapy in breast cancer patients prompted studies to evaluate potential clinical benefit of the drug in patients with HER2 positive gastric cancer. Unlike in breast cancer, the studies, in gastric cancer to date have yielded inconsistent findings regarding the frequency of HER-2 status. Furthermore, few studies have shown that intratumoral heterogeneity can lead to false negative results. All studies were done at the large medical centers. At the community hospital, we wish to assay HER-2 status intratumoral heterogeneity in patients with gastric cancer, and compare the results with that of large medical centers. Materials and Methods: We investigated 185 cases of gastric cancer specimens using immunohistochemistry (IHC) for HER2 status. The matched biopsy and resection specimen of 30 patients were also investigated for their correlation and the presence of intratumoral heterogeneity. Results: The positive HRE2 status was 29.7% (n=55), falling between the published data .One of two neuroendocrine tumors was HER2 positive, which was never reported before. We found the concordance rate of 83% in 30 matched biopsy and gastrectomy specimens; 57% of the gastrectomy specimens showed intratumoral heterogeneity. Conclusion: Anti-HER2 targeted therapy has been approved by FDA, Japan, and European Medicine Agency, as a standard initial treatment in HER2 positive gastric cancer. Overall, both biopsy and resection specimens are appropriate for HER-2 testing. The wide range of HER-2 frequency giving in the literature indicated that some problems exist. We are hoping that future study will clarify those confusing problems and standardized HER-2 assay method will become available. It is crucial for accurate selection of patients who could really benefit from a targeted therapy.
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