Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran

ABSTRACT Background Molecular targeted therapy and immunotherapy have shown promise in managing gastric adenocarcinoma. The amplified expression of Human epidermal growth factor receptor‐2 (HER‐2) and microsatellite stable (MSI) status serve as indicators of response to targeted therapy and immunoth...

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Main Authors: Samaneh Salarvand, Abbas Mohammadi, Reza Shahsiah, Farzaneh Bagheri, Mahsa Gholizadeh, Somayeh Jolany‐Vangah, Ebrahim Esmati, Marzieh Lashkari, Vahid Soleymani, Seraj Zareh‐Dehabadi, Vahid Mehrtash, Amirmohsen Jalaeefar, Mohammad Shirkhoda, Moones Toosang, Romina Abyaneh, Reza Ghalehtaki
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Cancer Reports
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Online Access:https://doi.org/10.1002/cnr2.70314
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author Samaneh Salarvand
Abbas Mohammadi
Reza Shahsiah
Farzaneh Bagheri
Mahsa Gholizadeh
Somayeh Jolany‐Vangah
Ebrahim Esmati
Marzieh Lashkari
Vahid Soleymani
Seraj Zareh‐Dehabadi
Vahid Mehrtash
Amirmohsen Jalaeefar
Mohammad Shirkhoda
Moones Toosang
Romina Abyaneh
Reza Ghalehtaki
author_facet Samaneh Salarvand
Abbas Mohammadi
Reza Shahsiah
Farzaneh Bagheri
Mahsa Gholizadeh
Somayeh Jolany‐Vangah
Ebrahim Esmati
Marzieh Lashkari
Vahid Soleymani
Seraj Zareh‐Dehabadi
Vahid Mehrtash
Amirmohsen Jalaeefar
Mohammad Shirkhoda
Moones Toosang
Romina Abyaneh
Reza Ghalehtaki
author_sort Samaneh Salarvand
collection DOAJ
description ABSTRACT Background Molecular targeted therapy and immunotherapy have shown promise in managing gastric adenocarcinoma. The amplified expression of Human epidermal growth factor receptor‐2 (HER‐2) and microsatellite stable (MSI) status serve as indicators of response to targeted therapy and immunotherapy, respectively. Aims This study assessed the frequency of MSI status and HER‐2 expression in a pretreated sample of Iranian patients with gastric and gastroesophageal (GE) adenocarcinoma. Methods and Results We conducted HER‐2/neu expression and mismatch repair (MMR) system analyses on specimens from patients with gastric and GE adenocarcinoma at the Cancer Institute of Iran. Archival tissues from 135 mainly pre‐treated surgical specimens of gastric adenocarcinoma cases were used for HER‐2 analysis, and 66 specimens were used for MSI analysis. All specimens were tested for HER‐2 amplification, revealing that 11 patients (8.1%) had HER‐2 amplification, and three out of 66 examined patients exhibited MSI‐H. Patients with HER‐2 overexpressed specimens had a shorter median overall survival (OS) compared with HER‐2 negative cases (21 months (95% CI: 1.4–40.6) vs. 31 months (95% CI: 22.9–39), p = 0.18). The median disease‐free survival (DFS) for HER‐2 positive and negative patients was 15 and 28 months, respectively (p = 0.25). The estimated median OS and DFS for patients with negative MSI were 26 and 20 months, respectively. However, none of the patients with MSI‐positive status experienced recurrence, metastases, or death within the follow‐up period; thus, MSI‐H patients had a significantly improved OS and DFS (p = 0.018 and 0.020). Conclusion HER‐2 expression, while less common in our Iranian population compared with North American or Western European countries, showed a nonsignificant trend toward poor outcomes in patients with gastric adenocarcinoma. MSI‐H status was highly infrequent in our population, suggesting that immunotherapy may not be a beneficial treatment for a significant fraction of Iranian patients with gastric adenocarcinoma. However, a minority may still benefit from it. MSI‐H was associated with reduced perineural invasion and improved OS and DFS. Therefore, this hypothesis warrants further investigation in clinical trials to underscore the prognostic significance of HER‐2 and MSI status and the value of molecular profiling in guiding personalized treatment strategies.
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spelling doaj-art-1808b9e8248d45c1b99f3fbc04ece09b2025-08-26T06:00:41ZengWileyCancer Reports2573-83482025-08-0188n/an/a10.1002/cnr2.70314Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of IranSamaneh Salarvand0Abbas Mohammadi1Reza Shahsiah2Farzaneh Bagheri3Mahsa Gholizadeh4Somayeh Jolany‐Vangah5Ebrahim Esmati6Marzieh Lashkari7Vahid Soleymani8Seraj Zareh‐Dehabadi9Vahid Mehrtash10Amirmohsen Jalaeefar11Mohammad Shirkhoda12Moones Toosang13Romina Abyaneh14Reza Ghalehtaki15Department of Clinical and Anatomical Pathology, Cancer Institute, School of Medicine Tehran University of Medical Sciences Tehran IranDepartment of Ophthalmology, School of Medicine Ahvaz Joundishapur University of Medical Sciences Ahvaz IranDepartment of Clinical and Anatomical Pathology, Cancer Institute, School of Medicine Tehran University of Medical Sciences Tehran IranDepartment of Radiation Oncology, Cancer Institute, IKHC, School of Medicine Tehran University of Medical Sciences Tehran IranDepartment of Radiation Oncology, Cancer Institute, IKHC, School of Medicine Tehran University of Medical Sciences Tehran IranDepartment of Radiation Oncology, Cancer Institute, IKHC, School of Medicine Tehran University of Medical Sciences Tehran IranDepartment of Radiation Oncology, Cancer Institute, IKHC, School of Medicine Tehran University of Medical Sciences Tehran IranRadiation Oncology Research Center, Cancer Research Institute Tehran University of Medical Sciences Tehran IranDepartment of Clinical and Anatomical Pathology, Cancer Institute, School of Medicine Tehran University of Medical Sciences Tehran IranRadiation Oncology Research Center, Cancer Research Institute Tehran University of Medical Sciences Tehran IranDepartment of Clinical and Anatomical Pathology, Cancer Institute, School of Medicine Tehran University of Medical Sciences Tehran IranDepartment of Oncosurgery, Cancer Institute, IKHC Tehran University of Medical Sciences Tehran IranDepartment of Oncosurgery, Cancer Institute, IKHC Tehran University of Medical Sciences Tehran IranDepartment of Clinical and Anatomical Pathology, Cancer Institute, School of Medicine Tehran University of Medical Sciences Tehran IranRadiation Oncology Research Center, Cancer Research Institute Tehran University of Medical Sciences Tehran IranDepartment of Radiation Oncology, Cancer Institute, IKHC, School of Medicine Tehran University of Medical Sciences Tehran IranABSTRACT Background Molecular targeted therapy and immunotherapy have shown promise in managing gastric adenocarcinoma. The amplified expression of Human epidermal growth factor receptor‐2 (HER‐2) and microsatellite stable (MSI) status serve as indicators of response to targeted therapy and immunotherapy, respectively. Aims This study assessed the frequency of MSI status and HER‐2 expression in a pretreated sample of Iranian patients with gastric and gastroesophageal (GE) adenocarcinoma. Methods and Results We conducted HER‐2/neu expression and mismatch repair (MMR) system analyses on specimens from patients with gastric and GE adenocarcinoma at the Cancer Institute of Iran. Archival tissues from 135 mainly pre‐treated surgical specimens of gastric adenocarcinoma cases were used for HER‐2 analysis, and 66 specimens were used for MSI analysis. All specimens were tested for HER‐2 amplification, revealing that 11 patients (8.1%) had HER‐2 amplification, and three out of 66 examined patients exhibited MSI‐H. Patients with HER‐2 overexpressed specimens had a shorter median overall survival (OS) compared with HER‐2 negative cases (21 months (95% CI: 1.4–40.6) vs. 31 months (95% CI: 22.9–39), p = 0.18). The median disease‐free survival (DFS) for HER‐2 positive and negative patients was 15 and 28 months, respectively (p = 0.25). The estimated median OS and DFS for patients with negative MSI were 26 and 20 months, respectively. However, none of the patients with MSI‐positive status experienced recurrence, metastases, or death within the follow‐up period; thus, MSI‐H patients had a significantly improved OS and DFS (p = 0.018 and 0.020). Conclusion HER‐2 expression, while less common in our Iranian population compared with North American or Western European countries, showed a nonsignificant trend toward poor outcomes in patients with gastric adenocarcinoma. MSI‐H status was highly infrequent in our population, suggesting that immunotherapy may not be a beneficial treatment for a significant fraction of Iranian patients with gastric adenocarcinoma. However, a minority may still benefit from it. MSI‐H was associated with reduced perineural invasion and improved OS and DFS. Therefore, this hypothesis warrants further investigation in clinical trials to underscore the prognostic significance of HER‐2 and MSI status and the value of molecular profiling in guiding personalized treatment strategies.https://doi.org/10.1002/cnr2.70314AdenocarcinomaDNA mismatch repairGastric neoplasmHER family receptor
spellingShingle Samaneh Salarvand
Abbas Mohammadi
Reza Shahsiah
Farzaneh Bagheri
Mahsa Gholizadeh
Somayeh Jolany‐Vangah
Ebrahim Esmati
Marzieh Lashkari
Vahid Soleymani
Seraj Zareh‐Dehabadi
Vahid Mehrtash
Amirmohsen Jalaeefar
Mohammad Shirkhoda
Moones Toosang
Romina Abyaneh
Reza Ghalehtaki
Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran
Cancer Reports
Adenocarcinoma
DNA mismatch repair
Gastric neoplasm
HER family receptor
title Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran
title_full Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran
title_fullStr Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran
title_full_unstemmed Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran
title_short Human Epidermal Growth Factor Receptor 2 [HER‐2/neu] Amplification and Microsatellite Stable Status in Gastric and Gastroesophageal Adenocarcinoma: Assessing Frequency and Prognostic Implications at the Cancer Institute of Iran
title_sort human epidermal growth factor receptor 2 her 2 neu amplification and microsatellite stable status in gastric and gastroesophageal adenocarcinoma assessing frequency and prognostic implications at the cancer institute of iran
topic Adenocarcinoma
DNA mismatch repair
Gastric neoplasm
HER family receptor
url https://doi.org/10.1002/cnr2.70314
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