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View Full Version : ASCO - IHC 1+ and 2+, and FISH 1-2 respond to Herceptin?


dlaxague
06-12-2007, 12:49 PM
Abstract No: 511

Citation: Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No.

18S (June 20 Supplement), 2007: 511

Author(s): S. Paik, C. Kim, J. Jeong, C. E. Geyer, E. H. Romond, O. Mejia-Mejia, E. P. Mamounas, D. Wickerham, J. P. Costantino, N. Wolmark

Abstract:

Background: Trastuzumab is a humanized monoclonal antibody targeted to HER2 protein and currently indicated for HER2-positive breast cancer defined by overexpression of HER2 protein (3+ IHC staining by HercepTest™) or HER2 gene amplification (HER2/CEP17 ratio over 2 by PathVysion® FISH assay). These criteria were determined for advanced disease but have not been formally tested in the adjuvant setting. We examined these tests' ability to predict benefit from adjuvant trastuzumab in NSABP trial B-31.

Methods: All available tumor tissue blocks from the B-31 trial were subjected to HercepTest and PathVysion assay as defined in the B-31 protocol.

Formal statistical test of interaction between

HER2 levels measured by these two tests and benefit from trastuzumab was performed.

Results: 207 of 1,795 cases (11.5%) showed gene amplification as determined by PathVysion, and

255 of 1,662 (15.3 %) showed overexpression as determined by HercepTest. 161 of 1,662 (9.7%) had neither gene amplification nor overexpression.

There was a consistent benefit from trastuzumab in every subset defined by IHC or FISH. No statistical interaction was found between DFS benefit from trastuzumab and levels of protein

(p=0.26) or HER2 gene copy number (p=0.60).

Benefit was observed in patients with tumors that were negative for FISH and had less than 3+ staining intensity on IHC by HercepTest (RR=0.36 [CI: 0.14-0.92] p=0.032).

Conclusion: Current definition of HER2 overexpression/gene amplification based on data from advanced disease may need to be modified for the adjuvant setting.

AlaskaAngel
06-12-2007, 02:26 PM
Interesting, Debbie. If so....

The criteria for the lapatinib for the early stage TEACH trial also is based on being either strongly FISH-positive or IHC+++, so perhaps that trial would be missing the target for some as well.

A.A.