Abstract

The extracellular domain of the HER-2 (ERBB2) oncoprotein (p105 HER-2, ECD HER-2) is shed in the serum and can be detected by immunoassay. The currently approved cutoff for an elevated HER-2 ECD is greater than 15 ng/mL. HER-2 ECD is attractive as a potentially useful serum biomarker. In metastatic breast cancer, serum assay of HER-2 ECD is recommended to assess HER-2 status when unknown in primary tumor or metastatic biopsy is not feasible. In that case, it has been recommended to consider a 50 ng/mL serum HER-2 ECD cutoff as criteria to select patients for HER-2 targeted therapy. It might offer additional prognostic or predictive value compared with HER-2 tumor tissue testing. In addition, it can be measured serially and might be able to monitor treatment response, predict relapse or provide a real-time assessment of HER-2 status at metastatic disease.

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