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HER2/neu testing in primary colorectal carcinoma
B Ingold Heppner1, H-M Behrens2, K Balschun2
1Department of Pathology, Campus Mitte, Charité University Hospital, 10117 Berlin, Germany.
Background:
Anti-HER2/neu therapy is well-established in breast and gastric carcinoma. The increased understanding of this pathway led to the identification of new promising drugs in addition to trastuzumab, offering further perspectives. The role of HER2/neu in colorectal carcinoma is controversially discussed, as discrepant data has been reported.
Methods:
Here, we retrospectively assessed the prevalence of HER2/neu positivity in a large series of colorectal carcinoma, testing HER2/neu status according to current recommendations. We correlated the results to clinico-pathological data and patient survival.
Results:
Overall, in 1645 primary colorectal carcinoma cases, 1.6% of the cases were HER2/neu positive. HER2/neu positivity significantly correlated with higher UICC stages (P=0.017) and lymph node metastases (P=0.029). In the subgroup of sigmoideal and rectal carcinomas, positive HER2/neu status was associated with T-category (P=0.041) and higher UICC stages (P=0.022). Although statistically not significant, HER2/neu-positive colorectal carcinomas displayed a tendency to poorer overall survival.
Conclusions:
These results illustrate the importance of testing HER2/neu by approved diagnostic techniques and scoring systems. We assume that although the prevalence of HER2/neu positivity in colorectal carcinoma is low, HER2/neu testing in advanced, nodal-positive colorectal carcinoma is reasonable, offering a potential target in high risk colorectal carcinoma.
Insights
HER2/neu positivity is found in 1.6% of colorectal cancers and is linked to advanced stages. Testing HER2/neu in high-risk patients may offer targeted therapy options.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Anti-HER2/neu therapy is established for breast and gastric cancers.
- The role of HER2/neu in colorectal carcinoma remains controversial with conflicting data.
- Understanding HER2/neu pathways has led to new therapeutic agents beyond trastuzumab.
Purpose of the Study:
- To determine the prevalence of HER2/neu positivity in a large cohort of colorectal carcinoma patients.
- To correlate HER2/neu status with clinico-pathological features and patient survival.
- To evaluate the potential of HER2/neu as a therapeutic target in colorectal cancer.
Main Methods:
- Retrospective analysis of 1645 primary colorectal carcinoma cases.
- HER2/neu status testing according to current diagnostic recommendations.
- Correlation of HER2/neu positivity with UICC stage, lymph node metastases, and T-category.
Main Results:
- HER2/neu positivity was observed in 1.6% of colorectal carcinomas.
- HER2/neu positivity significantly correlated with higher UICC stages and lymph node metastases.
- In sigmoidal and rectal carcinomas, HER2/neu positivity was associated with T-category and advanced UICC stages.
Conclusions:
- HER2/neu testing is crucial using validated diagnostic methods and scoring systems.
- Despite low prevalence, HER2/neu testing is recommended for advanced, nodal-positive colorectal cancer.
- HER2/neu represents a potential therapeutic target for high-risk colorectal carcinoma patients.
