Dissemin is shutting down on January 1st, 2025

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Karger Publishers, Oncology, 12(98), p. 884-888, 2020

DOI: 10.1159/000509148

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Outcomes of Advanced Gastroesophageal Cancer Patients with Equivocal HER2 Expression with or without ERBB2 Gene Amplification

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Data provided by SHERPA/RoMEO

Abstract

<b><i>Background:</i></b> Prior studies have shown that patients whose tumor overexpresses Her2 at 3+ level by immunohistochemistry (IHC) fare better than those whose tumor overexpresses Her2 at 2+ level (with <i>ERBB2</i> amplified). Therefore, it would be important to compare the outcome of patients whose tumor expresses Her2 at 2+ level but further classify by gene amplification studies as positive or negative. <b><i>Methods:</i></b> We retrospectively identified patients with advanced gastroesophageal adenocarcinoma with low Her2 protein expression (2+ by IHC) whose tumors were evaluated for gene amplification of <i>ERBB2</i> by fluorescence in situ hybridization (FISH). All patients received first-line therapy, and trastuzu­mab was added according to Her2 status. We compared overall survival (OS), progression-free survival (PFS), and overall response rate (ORR) of the entire cohort and compared Her2-positive tumor patients’ outcomes with Her2-negative tumor patients’ outcomes. All patients had treatment response assessments and follow-ups at our institution. <b><i>Results:</i></b> We identified 87 patients whose tumors expressed Her2 at 2+ level. 51 (58.6%) were Her2-negative and 36 (41.4%) were Her2-positive by FISH. For the entire cohort, the median OS was 26 months (95% confidence interval 16.6–37.6), and the median PFS was 12.2 months (95% confidence interval 9.7–19.3). Median OS, median PFS, and ORR did not differ between Her2-positive and Her2-negative patients (<i>p</i> = 0.70, <i>p</i> = 0.60, <i>p</i> = 0.91, respectively). <b><i>Conclusions:</i></b> Our data suggest that patients with Her2 positivity or negativity when tumors have lower Her2 protein expression (2 + by IHC) have similar clinical outcomes. Further research is warranted in this cohort.