J Breast Cancer.  2012 Jun;15(2):189-196. 10.4048/jbc.2012.15.2.189.

The Predictive Value of Serum HER2/neu for Response to Anthracycline-Based and Trastuzumab-Based Neoadjuvant Chemotherapy

• Lee JS
• Son BH
• Ahn SH

• KMID: 2242189
• DOI: http://doi.org/10.4048/jbc.2012.15.2.189

Abstract

PURPOSE
Little information exists about the possible influence of serum HER2/neu on response to chemotherapy. We propose that the assessment of serum HER2/neu in a pretreatment serum sample may be useful in predicting response to neoadjuvant chemotherapy.
METHODS
All breast cancer patients were tested by immunohistochemical stain and fluorescent in situ hybridization for HER2/neu before treatment. Serum HER2/neu was twice measured by chemiluminescence immunoassay (ADVIA Centaur System) before neoadjuvant chemotherapy and before operation. The cut-off value was 10.2 mg/mL, according to the previous study. Pathologic complete response (pCR) was considered as no residual tumor or remnant ductal carcinoma in situ; partial response (PR) was a less than 50% decrease in maximal diameter in pathologic tumor size. The measurements for the changes of serum HER2/neu were defined as pretreatment HER2/neu-preoperation HER2/neu. We compared the change of serum HER2/neu between that from before chemotherapy and that after chemotherapy, the pathologic complete response and partial response, and the trastuzumab group and anthracycline group.
RESULTS
Serum HER2/neu was decreased after neoadjuvant chemotherapy. The mean of serum HER2/neu in prechemotherapy was 15.4+/-9.0 ng/mL, and that of postchemotherapy was 10.5+/-2.0 ng/mL (p=0.04). Pathologic response was correlated with the change of serum HER2/neu (PR, 11.7+/-2.2 ng/mL vs. pCR, 23.7+/-13.1 ng/mL; p=0.01). In the trastuzumab group, pCR was marginally correlated with the change of serum HER2/neu (PR, 0.8+/-0.84 ng/mL vs. pCR, 21.1+/-13.2 ng/mL; p=0.08).
CONCLUSION
Serum HER2/neu levels during treatment were associated with pathologic response in patients receiving neoadjuvant chemotherapy, particularly, in a trastuzumab-based regimen. The change of serum HER2/neu levels may serve in monitoring neoadjuvant therapy in HER2/neu-overexpressed breast cancer.

Keyword

Breast neoplasms; HER2/neu; Trastuzumab

MeSH Terms

Antibodies, Monoclonal, Humanized
Breast Neoplasms
Carcinoma, Ductal
Humans
Immunoassay
In Situ Hybridization, Fluorescence
Luminescence
Neoadjuvant Therapy
Neoplasm, Residual
Polymerase Chain Reaction
Trastuzumab
Antibodies, Monoclonal, Humanized

Figure

• 

  Figure 1 Correlation between the prechemotherapy serum HER2/neu concentration and pathologic response. PR=partial response; CR=complete response.

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  Figure 2 Correlation between the change of serum HER2/neu concentration before and after neoadjuvant chemotherapy and pathologic response. PR=partial response; CR=complete response.

• 

  Figure 3 The receiver operating characteristics (ROC) curve analysis for prediction of pathologic response in 22 patients. Of these patients, 5 were treated with trastzumab in combination with taxane, and 17 with anthracycline. The curve shows pathologic response as a function of a prechemotherapy HER2/neu concentrations. The area under the curve is 0.829 (95% CI, 0.59-1.055).

• 

  Figure 4 The receiver operating characteristics (ROC) curve analysis for prediction of pathologic response in 22 patients. Of these patients, 5 were treated with trastzumab in combination with taxane, and 17 patients with anthracycline. The curve shows pathologic response as a function of the change of serum HER2/neu concentrations before and after neoadjuvant chemotherapy. The area under the curve is 0.782 (95% CI, 0.48-1.07).

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