Her2 extracelluar domain test
 

Does anyone know what the "serum HER2 extracellular domain (ECD) level" test is? I am assuming that it is not the same as the FISH or IHC tests that were done when we were first diagnosed with Her2+ breast cancer. I wonder if this test might become routine on new breast cancer cases, if as this abstract suggests it is a way to see how successful Herceptin might be.---bird


Anticancer Res. 2012 Apr;32(4):1429-33.
Elevated HER2 extracellular domain level in primary breast cancer with HER2 overexpression predicts early failure of adjuvant trastuzumab.

Thureau S, Clatot F, Laberge-Le-Couteulx S, Baron M, Basuyau JP, Blot E.
Source

Department of Radiotherapy, Henri Becquerel Center, Rouen, France. sebastien.thureau@chb.unicancer.fr

Abstract

AIM:

To investigate in a prospective study the prognostic value of serum HER2 extracellular domain (ECD) level in patients with primary breast cancer overexpressing HER2 treated with adjuvant chemotherapy and trastuzumab.
PATIENTS AND METHODS:

All the patients treated for primary breast cancer with chemotherapy and adjuvant trastuzumab from April 1, 2005 to December 31, 2006 at the Centre de Lutte Contre le Cancer de Haute Normandie were enrolled in this prospective study. HER2 ECD was measured in frozen serum by a commercial kit with a cut-off value of 15 ng/ml.
RESULTS:

Sixty-five patients were enrolled. Seven patients (11%) had an elevated serum HER2 ECD level (mean=25.1 ng/ml, range 15.1-38.9 ng/ml). During follow-up, 13 patients (20%) developed metastases and seven patients (11%) died. Death was related to breast cancer metastases in six patients (9%). Out of the seven patient with elevated serum HER2 ECD level, five (71%) developed metastases and three (43%) died of metastases during follow-up. Multivariate analysis showed that elevated serum HER2 ECD level was the unique factor for both disease-free survival (p<0.0006) and overall survival (p=0.008) in this series.
CONCLUSION:

Elevated serum HER2 ECD level is a strong prognostic factor in primary breast cancer overexpressing HER2 treated with adjuvant therapy of trastuzumab. In addition, our results suggest that it could predict failure of adjuvant therapy of trastuzumab.

Re: Her2 extracelluar domain test
 

I have the her2 serum test done, and we see it as a tumor marker, similar to the ca 27/29, etc.

I think the reliability is also similar to other tumor markers. For some, very reliable, but for others, not so much.

That being said, mine was at 14.9 the first time I had it tested and now is done to 12, so I am happy.


Laurie

Re: Her2 extracelluar domain test
 

Looks like this latest report is supportive. Been bouncing back and forth:
http://her2support.org/vbulletin/sho...48#post2256488

Re: Her2 extracelluar domain test
 

I think it has to do with the fact if your Her2+ BC has receptors (regular nice long ones that would be bound by Herceptin) or if you are the rare bird (yes - pun intended:)) that has the truncated receptors (tiny mis-formed ones) that cannot be bound by Herceptin.

Obviously, if you have the tiny mis-formed receptors, Herceptin cannot bind to them and work.

Re: Her2 extracelluar domain test
 

Yes, my doctor mentioned to me once about the possiblity of those truncated Her2 receptors being present. But he went on to say that Herceptin was really the only good choice I had, so truncated or not the Herceptin was applied. He's a pretty smart guy and I suspect if he felt the ECD test would have shed useful information on the efficacy of Herceptin in my case, he probably would have done it. Anyway, in this rare bird's case (I liked the pun Becky, btw) the 3 year cancerversary just passed and things are still looking good. So maybe those receptors I had were the good ones capable of easily catching Herceptin molecules....Thanks for all those links, Rich.--bird