Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?

Trastuzumab has recently been introduced as a treatment for HER2-positive metastatic and/or unresectable gastric cancer (MUGC); however, compared with breast cancer, some issues concerning HER2 and trastuzumab therapy for gastric cancer remain unclear. A 74-year-old woman received trastuzumab-contai...

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Main Authors: Yu Ishimine, Akira Goto, Yoshito Watanabe, Hidetaka Yajima, Suguru Nakagaki, Takashi Yabana, Takeya Adachi, Yoshihiro Kondo, Kiyoshi Kasai
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Gastrointestinal Medicine
Online Access:http://dx.doi.org/10.1155/2015/132030
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author Yu Ishimine
Akira Goto
Yoshito Watanabe
Hidetaka Yajima
Suguru Nakagaki
Takashi Yabana
Takeya Adachi
Yoshihiro Kondo
Kiyoshi Kasai
author_facet Yu Ishimine
Akira Goto
Yoshito Watanabe
Hidetaka Yajima
Suguru Nakagaki
Takashi Yabana
Takeya Adachi
Yoshihiro Kondo
Kiyoshi Kasai
author_sort Yu Ishimine
collection DOAJ
description Trastuzumab has recently been introduced as a treatment for HER2-positive metastatic and/or unresectable gastric cancer (MUGC); however, compared with breast cancer, some issues concerning HER2 and trastuzumab therapy for gastric cancer remain unclear. A 74-year-old woman received trastuzumab-containing chemotherapy for HER2-positive MUGC. She had a marked response to 8 months of chemotherapy, and gastrectomy and hepatic metastasectomy with curative intent were performed. The resected specimen showed complete loss of HER2 positivity in the residual tumor. For MUGC, a change in HER2 status during the course of the disease with or without chemotherapy has rarely been reported. However, in breast cancer, a significant frequency of change in HER2 status during the course of disease has been reported, and reevaluation of HER2 positivity in metastatic/recurrent sites is recommended. The choice of trastuzumab for MUGC is currently based on the HER2 status of the primary tumor at the time of initial diagnosis, without reassessment of HER2 status during the course of disease and/or in metastatic/recurrent sites, on the assumption that HER2 status is stable. However, our case casts doubt on the stability of HER2 in gastric cancer.
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spelling doaj-art-50eca7975d2d4bf08e9b38fa8f1e69ea2025-08-20T02:05:41ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362015-01-01201510.1155/2015/132030132030Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?Yu Ishimine0Akira Goto1Yoshito Watanabe2Hidetaka Yajima3Suguru Nakagaki4Takashi Yabana5Takeya Adachi6Yoshihiro Kondo7Kiyoshi Kasai8Department of Gastroenterology, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Gastroenterology, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Surgery, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University, S1W17, Chuo-ku, Sapporo 060-8556, JapanDepartment of Gastroenterology, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Gastroenterology, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Gastroenterology, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Gastroenterology, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanDepartment of Laboratory Medicine, Otaru General Hospital, 1-2-1 Wakamatu, Otaru 047-8550, JapanTrastuzumab has recently been introduced as a treatment for HER2-positive metastatic and/or unresectable gastric cancer (MUGC); however, compared with breast cancer, some issues concerning HER2 and trastuzumab therapy for gastric cancer remain unclear. A 74-year-old woman received trastuzumab-containing chemotherapy for HER2-positive MUGC. She had a marked response to 8 months of chemotherapy, and gastrectomy and hepatic metastasectomy with curative intent were performed. The resected specimen showed complete loss of HER2 positivity in the residual tumor. For MUGC, a change in HER2 status during the course of the disease with or without chemotherapy has rarely been reported. However, in breast cancer, a significant frequency of change in HER2 status during the course of disease has been reported, and reevaluation of HER2 positivity in metastatic/recurrent sites is recommended. The choice of trastuzumab for MUGC is currently based on the HER2 status of the primary tumor at the time of initial diagnosis, without reassessment of HER2 status during the course of disease and/or in metastatic/recurrent sites, on the assumption that HER2 status is stable. However, our case casts doubt on the stability of HER2 in gastric cancer.http://dx.doi.org/10.1155/2015/132030
spellingShingle Yu Ishimine
Akira Goto
Yoshito Watanabe
Hidetaka Yajima
Suguru Nakagaki
Takashi Yabana
Takeya Adachi
Yoshihiro Kondo
Kiyoshi Kasai
Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?
Case Reports in Gastrointestinal Medicine
title Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?
title_full Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?
title_fullStr Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?
title_full_unstemmed Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?
title_short Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?
title_sort loss of her2 positivity after trastuzumab in her2 positive gastric cancer is change in her2 status significantly frequent
url http://dx.doi.org/10.1155/2015/132030
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