激素受体和乳腺癌中的HER2测试:最近的问题得到了答案
Joanna Solarewicz1, Kimberly H Allison1
1Department of Pathology, Stanford Medicine, 300 Pasteur Drive, Stanford, CA, USA.
Surgical pathology clinics
|November 12, 2025
概括
病理学家必须更新乳腺癌生物标志物报告雌激素受体 (ER) 低阳性和HER2低/超低病例. 这些分类会影响治疗决策,特别是内分泌疗法和针对性治疗的资格,如trastuzumab-deruxtecan.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 生物标记分析 生物标记分析
背景情况:
- 随着数据的不断变化,需要对乳腺癌生物标志物解释进行调整.
- 雌激素受体 (ER) 低阳性和HER2低/超低不是不同的亚型,但具有重要的治疗影响.
- 准确的HER2评估对于有针对性的治疗资格至关重要.
研究的目的:
- 要突出乳腺癌生物标志物解释的不断变化的景观.
- 强调ER低阳性和HER2低/超低分类的临床意义.
- 为解决治疗指导准确区分HER2的必要性.
主要方法:
- 审查当前的乳腺癌生物标志物解释指南.
- 对临床试验数据的分析 (例如,DESTINY-Breast 04/06) 定义了HER2低/超低类别.
- 讨论HER2免疫组织化学 (IHC) 评分中的诊断挑战.
主要成果:
- 低ER阳性 (1%-10%) 癌症,虽然与ER阴性瘤相似,但可能从内分泌治疗中受益.
- 在关键试验中定义的HER2低和超低状态,决定了转移性乳腺癌中特鲁祖马布-德鲁克斯坦的适用性.
- 区分HER2 IHC 0 (没有染色) 和0+ (有些染色) 现在是临床上必不可少的.
结论:
- 病理学家必须调整报告以反映ER低阳性和HER2低/超低乳腺癌的治疗影响.
- 精确的HER2 IHC评分对于患者选择新疗法至关重要,尽管人们对可重现性的持续担忧.
- 这些不断变化的生物标志物解释对于优化乳腺癌治疗策略至关重要.
更多相关视频
相关概念视频
01:08Intracellular Hormone Receptors
Lipid-soluble hormones diffuse across the plasma and nuclear membrane of target cells to bind to their specific intracellular receptors. These receptors act as transcription factors that regulate gene expression and protein synthesis in the target cell
02:38Mitogens 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...
02:57Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
01:26Signal Transduction: Overview
Cells respond to many types of information, often through receptor proteins positioned on the membrane. They respond to chemical signals, such as hormones, neurotransmitters, and other signaling molecules, initiating a series of molecular reactions to produce an appropriate response. This is called signal transduction. Cells also coordinate different responses elicited by the same signaling molecule via mediators, allowing molecular cross-talk.
Typically, signal transduction involves three...
Typically, signal transduction involves three...
01:27Transducer Mechanism: Enzyme-Linked Receptors
Enzyme-linked receptors are cell-surface receptors acting as an enzyme or associating with an enzyme intracellularly. They make excellent drug targets. Drugs can bind to the extracellular ligand-binding domain or directly affect their enzymatic domain and alter their activity.
Major types that are helpful drug targets include:
Major types that are helpful drug targets include:
01:31Transducer Mechanism: Nuclear Receptors
Nuclear receptors, or NRs, are unique transcription factors that regulate gene transcription and affect the cellular pathways involved in reproduction, development, or metabolism. Their ability to be stimulated by small lipophilic ligands and control vital cellular processes makes them ideal drug targets. Nearly 10-15% of currently prescribed drugs target these receptors.
About 48 different soluble family members of nuclear receptors are identified that can be divided into two main classes:
About 48 different soluble family members of nuclear receptors are identified that can be divided into two main classes: