关于乳腺癌HER2报告的国际专家共识建议:专注于HER2-低和超低类别
Emad A Rakha1, Puay Hoon Tan2, Mieke R Van Bockstal3
1Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Pathology, Hamad Medical Corporation, Doha, Qatar.
现在,HER2阴性乳腺癌的分类包括HER2-低和HER2-超低的子集,这对于指导治疗trastuzumab deruxtecan (T-DXd) 治疗至关重要. 准确的病理报告对于识别可能受益于这种治疗的患者至关重要.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 生物标志物发现发现
背景情况:
- 传统的"HER2阴性"乳腺癌分类正在发展.
- 新兴的HER2-low和HER2-ultralow子集对向治疗具有临床意义.
- 特拉斯图祖马布德鲁克斯泰干 (T-DXd) 在HER2表达最小的患者中显示出生存益处.
研究的目的:
- 提供专家共识和实际建议,用于识别和报告HER2-low和HER2-ultralow乳腺癌.
- 为了使组织病理学实践与转移性乳腺癌的最新临床管理指南保持一致.
- 为准确的HER2表达评估提出一个标准化的病理报告模板.
主要方法:
- 对HER2-low (IHC 1+或2+没有放大) 和HER2-ultralow (IHC 0+/昏迷染色) 的临床试验定义的审查.
- 关于标准化测试协议,验证测试和质量保证的专家共识.
- 制定一个结构化的病理学报告,区分IHC 0 (无),IHC 0+ (超低) 和HER2-low.
主要成果:
- 对于T-DXd的监管批准现在包括患有HER2-低和HER2-超低转移性乳腺癌的患者.
- 更新的指导方针将HER2结果的频谱纳入治疗选择中.
- 一个拟议的报告模板明确区分了IHC 0,IHC 0+和HER2-low表达式.
结论:
- 准确识别和报告HER2-low和HER2-ultralow乳腺癌对于最佳的患者管理至关重要.
- 标准化测试,验证的测试和病理学家培训是解决关于测试可变性和可重复性问题的关键.
- 实施通用结构化病理学报告将提高转移性乳腺癌HER2生物标志物评估的准确性.
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