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Comparison of HER2 status in primary and paired metastatic sites of gastric carcinoma.

Bozzetti C, Negri FV, Lagrasta CA, Crafa P, Bassano C, Tamagnini I, Gardini G, Nizzoli R, Leonardi F, Gasparro D, Camisa R, Cavalli S, Capelli S, Silini EM, Ardizzoni A - Br. J. Cancer (2011)

Bottom Line: Concordance of FISH results, evaluable in 68 primary and matched metastatic sites, was 98.5%.Concordance of IHC results, available in 39 of the 72 paired cases, was 94.9%.The high concordance observed between HER2 results obtained by both IHC and FISH on primary tumours and corresponding metastases suggests that in gastric cancer HER2 status is maintained in most cases unchanged during the metastatic process.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Via Gramsci 14, Parma 43126, Italy. cbozzetti@ao.pr.it

ABSTRACT

Background: Trastuzumab has recently shown efficacy in the treatment of HER2-positive advanced gastric adenocarcinoma. Although antibody-based therapies target the metastatic disease, HER2 status is usually evaluated in the primary tumour because metastatic sites are rarely biopsied. The aim of this study was to compare HER2 status in primary and paired metastatic sites of gastric adenocarcinoma.

Methods: The HER2 status was assessed by fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) in 72 secondary lesions of gastric adenocarcinoma and in the corresponding primary tumours.

Results: Concordance of FISH results, evaluable in 68 primary and matched metastatic sites, was 98.5%. Concordance of IHC results, available in 39 of the 72 paired cases, was 94.9%. Only one case showed discordance between primary tumour and metastasis, being negative by both IHC and FISH in the primary and showing HER2 overexpression and amplification in the corresponding pancreatic lymph node metastasis.

Conclusion: The high concordance observed between HER2 results obtained by both IHC and FISH on primary tumours and corresponding metastases suggests that in gastric cancer HER2 status is maintained in most cases unchanged during the metastatic process.

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Related in: MedlinePlus

The HER2 cluster amplification (A) and protein overexpression (B) in the lymph node metastasis of the primary gastric carcinoma shown in Figure 1. Original magnification: (A) × 1250; (B) × 400.
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fig2: The HER2 cluster amplification (A) and protein overexpression (B) in the lymph node metastasis of the primary gastric carcinoma shown in Figure 1. Original magnification: (A) × 1250; (B) × 400.

Mentions: Among the 68 cases assayed by FISH on both primary and paired metastatic site, 10 cases were amplified in both specimens (Table 2). In all, 9 of the 10 cases showed a cluster amplification in both primary and metastasis; the tumour with heterogeneous HER2 amplification in the primary showed an increase in both HER2 gene copy number (4.5 vs 12.0) and the percentage of amplified cells (33 vs 90%) in the matched metastasis. A single case showed primary vs metastasis discordance, being unamplified in the primary tumour (Figure 1A) and exhibiting a cluster amplification in 20% of tumour cells in the matched synchronous pancreatic lymph node biopsy (Figure 2A).


Comparison of HER2 status in primary and paired metastatic sites of gastric carcinoma.

Bozzetti C, Negri FV, Lagrasta CA, Crafa P, Bassano C, Tamagnini I, Gardini G, Nizzoli R, Leonardi F, Gasparro D, Camisa R, Cavalli S, Capelli S, Silini EM, Ardizzoni A - Br. J. Cancer (2011)

The HER2 cluster amplification (A) and protein overexpression (B) in the lymph node metastasis of the primary gastric carcinoma shown in Figure 1. Original magnification: (A) × 1250; (B) × 400.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3101935&req=5

fig2: The HER2 cluster amplification (A) and protein overexpression (B) in the lymph node metastasis of the primary gastric carcinoma shown in Figure 1. Original magnification: (A) × 1250; (B) × 400.
Mentions: Among the 68 cases assayed by FISH on both primary and paired metastatic site, 10 cases were amplified in both specimens (Table 2). In all, 9 of the 10 cases showed a cluster amplification in both primary and metastasis; the tumour with heterogeneous HER2 amplification in the primary showed an increase in both HER2 gene copy number (4.5 vs 12.0) and the percentage of amplified cells (33 vs 90%) in the matched metastasis. A single case showed primary vs metastasis discordance, being unamplified in the primary tumour (Figure 1A) and exhibiting a cluster amplification in 20% of tumour cells in the matched synchronous pancreatic lymph node biopsy (Figure 2A).

Bottom Line: Concordance of FISH results, evaluable in 68 primary and matched metastatic sites, was 98.5%.Concordance of IHC results, available in 39 of the 72 paired cases, was 94.9%.The high concordance observed between HER2 results obtained by both IHC and FISH on primary tumours and corresponding metastases suggests that in gastric cancer HER2 status is maintained in most cases unchanged during the metastatic process.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Via Gramsci 14, Parma 43126, Italy. cbozzetti@ao.pr.it

ABSTRACT

Background: Trastuzumab has recently shown efficacy in the treatment of HER2-positive advanced gastric adenocarcinoma. Although antibody-based therapies target the metastatic disease, HER2 status is usually evaluated in the primary tumour because metastatic sites are rarely biopsied. The aim of this study was to compare HER2 status in primary and paired metastatic sites of gastric adenocarcinoma.

Methods: The HER2 status was assessed by fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) in 72 secondary lesions of gastric adenocarcinoma and in the corresponding primary tumours.

Results: Concordance of FISH results, evaluable in 68 primary and matched metastatic sites, was 98.5%. Concordance of IHC results, available in 39 of the 72 paired cases, was 94.9%. Only one case showed discordance between primary tumour and metastasis, being negative by both IHC and FISH in the primary and showing HER2 overexpression and amplification in the corresponding pancreatic lymph node metastasis.

Conclusion: The high concordance observed between HER2 results obtained by both IHC and FISH on primary tumours and corresponding metastases suggests that in gastric cancer HER2 status is maintained in most cases unchanged during the metastatic process.

Show MeSH
Related in: MedlinePlus