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Validated Immunochemical Assay for Comprehensive Determination of the Human Epidermal Growth Factor Receptor 2 Released from and Bound to Cells
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The potential for targeting HER2 therapeutically in esophageal cancer - a grasp at straws?
Faik G Uzunoglu1, Alexandra M Koenig, Jakob R Izbicki
1University Medical Center Hamburg-Eppendorf, Department of General, Visceral and Thoracic Surgery , Hamburg-Eppendorf Martinistr. 52, 20246 Hamburg , Germany.
Introduction:
Human EGFR-2 (HER2) has an impact on cellular proliferation and survival. HER2 overexpression has been shown to be a marker for poorer prognosis in several malignancies. Trastuzumab, a humanized mAb, is successfully used to target HER2 in breast cancer. The effect of targeting HER2 in esophageal cancer (EC) is the focus of current trials.
Areas Covered:
Basic knowledge, detection techniques and definitions of HER2 overexpression, as well as the molecular mechanisms underlying the effects of trastuzumab on HER2, are reviewed. An overview of research on the prognostic and predictive relevance of HER2 in EC is given, as well as an overview of current trials targeting HER2 in EC.
Expert Opinion:
The first aim of novel targeted therapies must be perioperative neoadjuvant and adjuvant applications, as surgery is the only option for curative treatment in patients with stage I - III EC. Regarding targeted therapies in EC, HER2 is currently the most promising target. Trials of trimodal neoadjuvant therapy regimes (neoadjuvant radiochemotherapy plus trastuzumab) are currently recruiting. However, the prognostic impact of HER2 overexpression in EC remains ambiguous. Targeting HER2 may have negative and positive impacts on survival, depending on which subgroup of EC patients is treated.
Insights
Human Epidermal Growth Factor Receptor 2 (HER2) shows promise as a target for esophageal cancer treatment. While trastuzumab is effective in breast cancer, its impact on esophageal cancer survival remains under investigation.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- Human Epidermal Growth Factor Receptor 2 (HER2) influences cell growth and survival.
- HER2 overexpression is linked to poorer prognosis in various cancers.
- Trastuzumab, a monoclonal antibody, targets HER2 effectively in breast cancer.
Purpose of the Study:
- To review the role of HER2 in esophageal cancer (EC).
- To examine the potential of targeting HER2 in EC treatment.
- To provide an overview of current clinical trials investigating HER2-targeted therapies in EC.
Main Methods:
- Review of basic knowledge, detection techniques, and definitions of HER2 overexpression.
- Analysis of molecular mechanisms of trastuzumab's action on HER2.
- Compilation of research on the prognostic and predictive relevance of HER2 in EC.
Main Results:
- HER2 is a promising target for esophageal cancer therapies.
- Current trials are exploring neoadjuvant therapy regimens including trastuzumab.
- The prognostic significance of HER2 overexpression in EC is still debated.
Conclusions:
- Perioperative neoadjuvant and adjuvant targeted therapies are crucial for stages I-III EC.
- HER2-targeted therapy may have variable effects on survival depending on the patient subgroup.
- Further research is needed to clarify the precise role and impact of HER2 targeting in EC.
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