Abstract
Background: HER2/neu oncogene overexpression and amplification in breast cancer is well known. Studies have proved its role in gastric cancer and its correlation with the prognosis. Very few studies are there in literature regarding HER2/neu expression in entire gastrointestinal carcinoma. Our study was aimed at HER2/neu expression in gastrointestinal tumors in South Indian Population. M ethods: We included all patients with gastrointestinal carcinoma who either underwent biopsy or surgical excision over the past five years. Slides were reviewed for confirmation of the diagnosis and immunohistochemistry was done using SP3 monoclonal anti-HER2 antibodies. Three independent observers did the scoring for HER2 positivity. Results: Among 35 cases of gastric cancer, only 2 (5.7%) females showed positivity for HER2 scoring and one (2.9%) female showed an equivocal result. All positive and equivocal cases in gastric cancer were intestinal type. Both the cases with HER2 positivity were poorly differentiated tumors. The one with equivocal was a moderately differentiated carcinoma. In colorectal cancer out of 19 cases, only one (5.3%) showed positivity for HER2 whereas in one there was an equivocal response. All the seven cases of small intestinal carcinoma showed negative results for HER2 expression. Conclusion: Overall, HER2/neu expression in gastrointestinal cancer was 4.9%. Female gender, intestinal- type and poorly differentiated cancer showed positivity in gastric cancer. Female gender, left side and low-grade tumor showed positivity in colorectal cancer. Further studies are required with a large sample size to correlate HER2 expression with clinicopathological parameters and its role in prognosis in gastrointestinal carcinomas in the Indian population.
Highlights
Gastrointestinal carcinoma is one of the leading causes of cancer-related deaths worldwide, especially in gastric and colorectal carcinomas. [1,2]Small intestinal carcinoma is rare. [3] Recently the search for newer therapeutic regimens has focused on HER2/neu (Human Epidermal Growth factor receptor) expression and gene amplification
An evidence-based clinical practice guideline on HER2 testing for patients with gastroesophageal cancers was recently released by American society of clinical oncology (ASCO), College of American Pathologists (CAP) and the American Society for Clinical Pathology (ASCP) and recommends that HER2 status should be established in all patients with advanced gastroesophageal adenocarcinoma who are eligible for systemic therapy.[5]recent trials like HERACLES and MyPathway suggested the possibility of HER2 blockade as a targeted therapy in advanced colorectal carcinoma (CRC) patients.[6,7]Together, the trials supported preclinical results that targeting HER2 with trastuzumab plus either lapatinib or pertuzumab is more effective than standard combination chemotherapy in HER2-positive CRC patients
Out of 61 cases, gastric carcinoma accounted for 35(57%) cases followed by 19(31%) cases of colorectal carcinoma and 7(12%) cases of small intestinal carcinoma
Summary
Gastrointestinal carcinoma is one of the leading causes of cancer-related deaths worldwide, especially in gastric and colorectal carcinomas. [1,2]Small intestinal carcinoma is rare. [3] Recently the search for newer therapeutic regimens has focused on HER2/neu (Human Epidermal Growth factor receptor) expression and gene amplification. [3] Recently the search for newer therapeutic regimens has focused on HER2/neu (Human Epidermal Growth factor receptor) expression and gene amplification This has been studied as a therapeutic and prognostic target using a monoclonal antibody against HER2 /neu in a number of human cancers including breast, gastric, colorectal and lung carcinoma.[4] An evidence-based clinical practice guideline on HER2 testing for patients with gastroesophageal cancers was recently released by American society of clinical oncology (ASCO), College of American Pathologists (CAP) and the American Society for Clinical Pathology (ASCP) and recommends that HER2 status should be established in all patients with advanced gastroesophageal adenocarcinoma who are eligible for systemic therapy.[5]recent trials like HERACLES and MyPathway suggested the possibility of HER2 blockade as a targeted therapy in advanced colorectal carcinoma (CRC) patients.[6,7]Together, the trials supported preclinical results that targeting HER2 with trastuzumab plus either lapatinib or pertuzumab is more effective than standard combination chemotherapy in HER2-positive CRC patients. We decided to study the HER2 expression in carcinoma of the entire gastrointestinal tract including gastric, colorectum and small intestine in the South Indian population. Our study was aimed at HER2/neu expression in gastrointestinal tumors in South Indian Population
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