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Updated: Jun 10, 2026
Validated Immunochemical Assay for Comprehensive Determination of the Human Epidermal Growth Factor Receptor 2 Released from and Bound to Cells
Published on: May 9, 2025
Towards detecting the HER-2 receptor and metabolic changes induced by HER-2-targeted therapies using medical imaging
1School of Medical Sciences, Biomedical Physics Building, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK. t.smith@abdn.ac.uk
Abstract:
HER-2/neu (a receptor for human epidermal growth factor) is involved in cell survival, proliferation, angiogenesis and invasiveness. It is overexpressed in about 25% of breast cancers. Overexpression of HER-2 is associated with response to the anti-HER-2 antibody trastuzumab (herceptin). However, HER-2 expression can be heterogeneous within the primary tumour and can also exhibit discordant expression between a primary tumour and its metastases, bringing into question the practice of HER-2 screening to determine whether a patient is a candidate for trastuzumab using material obtained only from the primary tumour. Medical imaging modalities using HER-2-targeted tracers (or contrast agents) facilitate a global approach to the determination of HER-2 expression across all detectable tumour lesions, and could provide a more reliable indication of the patient's likely response to trastuzumab treatment. Here, I review the development and pre-clinical (and occasional clinical) assessment of HER-2-targeted tracers. I discuss studies in which established imaging tracers, such as (11)C-choline, have been used to determine response to trastuzumab in a range of medical imaging modalities, including positron emission tomography (PET), single photon emission tomography (SPECT), MRI and optical imaging.
Insights
Medical imaging tracers targeting HER-2/neu (human epidermal growth factor receptor 2) offer a global assessment of cancer lesions. This approach may better predict response to trastuzumab therapy than primary tumor screening alone.
Area of Science:
- Oncology
- Radiology
- Molecular Imaging
Background:
- HER-2/neu receptor tyrosine kinase is crucial for cell growth and is overexpressed in approximately 25% of breast cancers.
- HER-2/neu overexpression correlates with response to trastuzumab (Herceptin) therapy.
- Tumor heterogeneity and discordant HER-2/neu expression between primary and metastatic sites challenge traditional biopsy-based screening for trastuzumab candidacy.
Purpose of the Study:
- To review the development and assessment of HER-2/neu-targeted imaging tracers.
- To explore the utility of these tracers in predicting trastuzumab treatment response.
- To evaluate medical imaging modalities for global HER-2/neu expression determination.
Main Methods:
- Review of pre-clinical and clinical studies on HER-2/neu-targeted tracers.
- Analysis of established imaging tracers, such as (11)C-choline, in various medical imaging modalities.
- Assessment of imaging techniques including PET, SPECT, MRI, and optical imaging.
Main Results:
- HER-2-targeted tracers enable a comprehensive assessment of HER-2/neu expression across all detectable tumor lesions.
- Medical imaging modalities facilitate a global evaluation of HER-2/neu status, potentially overcoming limitations of localized tumor biopsies.
- Studies utilizing tracers like (11)C-choline demonstrate potential in assessing response to trastuzumab therapy.
Conclusions:
- HER-2-targeted imaging tracers provide a more reliable method for determining patient eligibility for trastuzumab treatment.
- Global assessment of HER-2/neu expression via imaging can improve therapeutic decision-making in HER-2-positive cancers.
- The development and application of these tracers represent a significant advancement in personalized oncology.
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