Mind the target: human epidermal growth factor receptor 2 in colorectal cancer

Rita Saúde-Conde1, Gertjan Rasschaert1,2, Giacomo Bregni1,3

  • 1Gastrointestinal Unit - Department of Medical Oncology, Institut Jules Bordet.

Abstract

Insights

Human epidermal growth factor receptor 2 (HER2) alterations are a targetable vulnerability in 5% of metastatic colorectal cancer (CRC) patients. Emerging anti-HER2 therapies show promise, with liquid biopsies aiding patient selection.

Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Pharmacology

Background:

  • Colorectal cancer (CRC) is a significant global health concern.
  • Human epidermal growth factor receptor 2 (HER2) alterations occur in approximately 5% of metastatic CRC cases.
  • HER2 status impacts treatment strategies and patient outcomes.

Purpose of the Study:

  • To summarize current knowledge on HER2 alterations in CRC.
  • To review recent evidence on HER2 detection, prognostication, and targeted treatments.
  • To highlight challenges in standardizing HER2 diagnostics for clinical practice.

Main Methods:

  • Literature review of recent studies on HER2 in CRC.
  • Analysis of evidence regarding anti-HER2 therapies (monotherapy, combination, antibody-drug conjugates, tyrosine kinase inhibitors).
  • Evaluation of liquid biopsy and ctDNA analyses for HER2 detection and patient selection.

Main Results:

  • Established and novel anti-HER2 agents demonstrate therapeutic potential in CRC.
  • Liquid biopsy and ctDNA analysis are confirmed as valuable tools for HER2 detection and patient selection.
  • Standardization of HER2 detection methods and diagnostic criteria is crucial.

Conclusions:

  • Targeting HER2 in CRC, despite its rarity, offers significant therapeutic opportunities.
  • Further high-quality, randomized evidence is needed to support regulatory approval and routine clinical use of anti-HER2 agents.
  • Standardization of diagnostic approaches is a key challenge for advancing HER2-targeted therapy in CRC.

Related Concept Videos

Mitogens and the Cell Cycle02:38

Mitogens and the Cell Cycle

Mitogens and their receptors play a crucial role in controlling the progression of the cell cycle. However, the loss of mitogenic control over cell division leads to tumor formation. Therefore, mitogens and mitogen receptors play an important role in cancer research. For instance, the epidermal growth factor (EGF) - a type of mitogen and its transmembrane receptor (EGFR), decides the fate of the cell's proliferation. When EGF binds to EGFR, a member of the ErbB family of tyrosine kinase...
6.6K
Role of Ephrin-Eph Signalling in Intestinal Stem Cell Renewal01:22

Role of Ephrin-Eph Signalling in Intestinal Stem Cell Renewal

Erythropoietin-producing hepatocellular carcinoma receptor (Eph) and its ligand, Eph receptor-interacting protein (Ephrin) were first discovered in the human carcinoma cell line, hence the name. Ephrin-Eph interaction guides cells to reach their appropriate location in adult tissues. They also play an essential role in the immune system by helping in immune cell migration, adhesion, and activation. Based on their structure and function, Eph is divided into two classes — EphA and EphB.
2.3K
mTOR Signaling and Cancer Progression03:03

mTOR Signaling and Cancer Progression

The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...
3.9K
Tumor Progression02:07

Tumor Progression

Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
6.5K
Cancer-Critical Genes II: Tumor Suppressor Genes01:05

Cancer-Critical Genes II: Tumor Suppressor Genes

Genes usually encode proteins necessary for the proper functioning of a healthy cell. Mutations can often cause changes to the gene expression pattern, thereby altering the phenotype.
When the function of certain critical genes, especially those involved in cell cycle regulation and cell growth signaling cascades, gets disrupted, it upsets the cell cycle progression. Such cells with unchecked cell cycles start proliferating uncontrollably and eventually develop into tumors.
Such genes that act...
7.9K
The Ras Gene02:38

The Ras Gene

The Ras-gene-encoded proteins are regulators of signaling pathways controlling cell proliferation, differentiation, or cell survival. The Ras-gene family in humans constitutes three primary members—the HRas, NRas, and KRas. These genes code for four functionally distinct yet closely related proteins—the HRas, NRas, KRas4A, and KRas4B. The involvement of mutant Ras genes in human cancer was first discovered in 1982 and is among the most common causes of human tumorigenesis.
Ras is a...
6.4K