Ozge Gumusay1, Mustafa Benekli2, Ozgur Ekinci3, Meltem Baykara4, Ahmet Ozet2, Ugur Coskun2, Umut Demirci5, Aytug Uner2, Ayse Dursun3, Ecine Yesim Atak3, Suleyman Buyukberber2. 1. Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara ozgebostankolu@hotmail.com. 2. Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara. 3. Department of Pathology, Gazi University Faculty of Medicine, Ankara. 4. Department of Internal Medicine, Division of Medical Oncology, Sakarya Education and Research Hospital, Sakarya. 5. Department of Internal Medicine, Division of Medical Oncology, Dr. Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Turkey.
Abstract
OBJECTIVE: Determination of human epidermal growth factor receptor-2 status in advanced gastric cancer is important in clinical decision making. In the trastuzumab for GC trial, trastuzumab-based therapy demonstrated a significant overall survival benefit in patients with human epidermal growth factor receptor-2-positive advanced gastric cancer. Human epidermal growth factor receptor-2 discordance in gastric cancer primary and its metastases has been long debated. The aim of the study was to evaluate the rate of human epidermal growth factor receptor-2 discordance and its effect on treatment decisions in advanced gastric cancer. METHODS: A total of 74 patients with advanced gastric cancer were included in the study. Both immunohistochemical staining and dual-color silver in situ hybridization were performed in all patients to evaluate the human epidermal growth factor receptor-2 status of the primary lesion and paired metastasis. RESULTS: The assessment of human epidermal growth factor receptor-2 status with the immunohistochemical staining method and dual-color silver in situ hybridization revealed a discordance rate of 9.5 and 16.2%, respectively. However, this discordance was clinically meaningful in only one patient leading to a change in treatment decision. While this patient had a human epidermal growth factor receptor-2-negative status in primary tumor (immunohistochemical = 0, dual-color silver in situ hybridization = negative), the human epidermal growth factor receptor-2 status was positive for liver metastasis (immunohistochemical = 2+, dual-color silver in situ hybridization = positive). Trastuzumab was added to the chemotherapy regimen. CONCLUSIONS: In this study, we found a higher rate of human epidermal growth factor receptor-2 discordance between primary gastric tumor and metastatic lesions compared with the rates reported in previous studies. Detection of a human epidermal growth factor receptor-2-positive metastasis with a human epidermal growth factor receptor-2-negative primary tumor suggests that investigation of human epidermal growth factor receptor-2 is also required for the metastatic lesion and that trastuzumab could be administered in the case of a positive result.
OBJECTIVE: Determination of humanepidermal growth factor receptor-2 status in advanced gastric cancer is important in clinical decision making. In the trastuzumab for GC trial, trastuzumab-based therapy demonstrated a significant overall survival benefit in patients with humanepidermal growth factor receptor-2-positive advanced gastric cancer. Humanepidermal growth factor receptor-2 discordance in gastric cancer primary and its metastases has been long debated. The aim of the study was to evaluate the rate of humanepidermal growth factor receptor-2 discordance and its effect on treatment decisions in advanced gastric cancer. METHODS: A total of 74 patients with advanced gastric cancer were included in the study. Both immunohistochemical staining and dual-color silver in situ hybridization were performed in all patients to evaluate the humanepidermal growth factor receptor-2 status of the primary lesion and paired metastasis. RESULTS: The assessment of humanepidermal growth factor receptor-2 status with the immunohistochemical staining method and dual-color silver in situ hybridization revealed a discordance rate of 9.5 and 16.2%, respectively. However, this discordance was clinically meaningful in only one patient leading to a change in treatment decision. While this patient had a humanepidermal growth factor receptor-2-negative status in primary tumor (immunohistochemical = 0, dual-color silver in situ hybridization = negative), the humanepidermal growth factor receptor-2 status was positive for liver metastasis (immunohistochemical = 2+, dual-color silver in situ hybridization = positive). Trastuzumab was added to the chemotherapy regimen. CONCLUSIONS: In this study, we found a higher rate of humanepidermal growth factor receptor-2 discordance between primary gastric tumor and metastatic lesions compared with the rates reported in previous studies. Detection of a humanepidermal growth factor receptor-2-positive metastasis with a humanepidermal growth factor receptor-2-negative primary tumor suggests that investigation of humanepidermal growth factor receptor-2 is also required for the metastatic lesion and that trastuzumab could be administered in the case of a positive result.
Authors: A Creemers; E Ter Veer; L de Waal; P Lodder; G K J Hooijer; N C T van Grieken; M F Bijlsma; S L Meijer; M G H van Oijen; H W M van Laarhoven Journal: Sci Rep Date: 2017-06-09 Impact factor: 4.379