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Journal of Laboratory Medicine

Official Journal of the German Society of Clinical Chemistry and Laboratory Medicine

Editor-in-Chief: Schuff-Werner, Peter

Ed. by Ahmad-Nejad, Parviz / Bidlingmaier, Martin / Bietenbeck, Andreas / Conrad, Karsten / Findeisen, Peter / Fraunberger, Peter / Ghebremedhin, Beniam / Holdenrieder, Stefan / Kiehntopf, Michael / Klein, Hanns-Georg / Kohse, Klaus P. / Kratzsch, Jürgen / Luppa, Peter B. / Meyer, Alexander von / Nebe, Carl Thomas / Orth, Matthias / Röhrig-Herzog, Gabriele / Sack, Ulrich / Steimer, Werner / Weber, Thomas / Wieland, Eberhard / Winter, Christof / Zettl, Uwe K.


IMPACT FACTOR 2018: 0.389

CiteScore 2018: 0.22

SCImago Journal Rank (SJR) 2018: 0.156
Source Normalized Impact per Paper (SNIP) 2018: 0.089

Online
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2567-9449
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Volume 38, Issue 6

Issues

Clinical use of S-HER2 in breast cancer for detecting metastatic recurrence and monitoring effect of trastuzumab treatment

Der klinische Nutzen von S-HER2 für den Nachweis wiederauftretender Metastasen bei Brustkrebs und Verlaufskontrolle der Behandlung mit Trastuzumab

Ina Mathilde Kjær / Ivan Brandslund
Published Online: 2014-12-02 | DOI: https://doi.org/10.1515/labmed-2014-0040

Abstract

In 15%–20% of breast cancers, human epidermal growth factor receptor 2 (HER2) is overexpressed. Part of HER2 is shed into the circulation, where it can be measured in serum as S-HER2. Although many studies have tried to establish the clinical usefulness of S-HER2, S-HER2 has not yet found its place in clinical practice because large prospective trials have been missing. We present our own recent work to provide a suggestion of the clinical use of S-HER2. A total of 540 patients were followed up after primary surgery. The sensitivity of detection of recurrence in tissue HER2-positive patients was 69% and the positive predictive value was 47% using a cutoff value of 15 μg/L. Further, we have shown that the S-HER2 value reflects the effect of targeted treatment with trastuzumab. An increase in S-HER2 was correlated with progression of disease in 40 out of 44 clinical courses, whereas a decrease in S-HER2 was correlated to no progression or regression in 20 out of 21 courses. We propose to include S-HER2 in the clinical follow-up after primary surgery of tissue HER2-positive breast cancer patients to detect recurrence. We suggest a prospective randomized trial on the individualized, tailored therapy of these patients using S-HER2 as an indicator of the need to investigate recurrence.

Zusammenfassung

In 15%–20% der Fälle von Brustkrebs ist die Anzahl der Wachstumsfaktorrezeptoren HER2 (human epidermal growth factor receptor 2) erhöht. Ein Teil davon gelangt in den Keislauf und kann im Serum als S-HER2 gemessen werden. In vielen Studien wurde bereits der Versuch unternommen, den Nachweis für den klinischen Nutzen von S-HER2 zu erbringen, jedoch hat S-HER2 aufgrund fehlender umfangreicher prospektiver Studien seinen Platz in der klinischen Praxis beisher noch nicht gefunden. Wir stellen die Ergebnisse unserer neuesten Arbeit vor mit dem Vorschlag S-HER2 in der klinischen Praxis zu nutzen. An unserer Studie nahmen 540 Patienten nach Primäreingriff teil. Die Sensivität für den Nachweis eines Rezidivs bei HER2-positiven Patienten betrug 69%, der positive prädiktive Wert betrug 47% bei einem Cutoff von 15 μg/L. Wir haben auch gezeigt, dass sich die gezielten Behandlung mit Trastuzumab auf die S-HER2 Werten auswirken. Erhöhte S-HER2 Werte korrelierten mit dem Fortschreiten der Krankheit bei 40 von 44 klinischen Fällen, wohingegen verringerte S-HER2 Werte mit einem Stillstand der Krankheit bei 20 von 21 Fällen korrilierten. Für den Nachweis von Rezidiven empfehlen wir die Messung von S-HER2 bei der klinischen Verlaufskontrolle nach Primäreingriff bei HER2-positiven Patientinnen mit Brustkrebs.

Reviewed publication

HoldenriederS.

Keywords: breast cancer; human epidermal growth factor receptor 2 (HER2); metastatic recurrence; trastuzumab

Schlüsselwörter: Brustkrebs; HER2; Rezidiv; Trastuzumab

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About the article

Correspondence: Ina Mathilde Kjær, MD, Department of Clinical Biochemistry, Vejle Hospital, Kabbeltoft 25, 7100 Vejle, Denmark, E-Mail:


Received: 2014-10-24

Accepted: 2014-11-06

Published Online: 2014-12-02

Published in Print: 2014-12-01


Citation Information: LaboratoriumsMedizin, Volume 38, Issue 6, Pages 325–331, ISSN (Online) 1439-0477, ISSN (Print) 0342-3026, DOI: https://doi.org/10.1515/labmed-2014-0040.

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