Skip to main content

Advertisement

SpringerLink
Log in

A case of advanced gastric cancer showing HER2 positivity after chemotherapy

  • Case report
  • Published:
International Cancer Conference Journal Aims and scope Submit manuscript

Abstract

A 63-year-old man had advanced poorly differentiated gastric adenocarcinoma with para-aortic lymph node metastases. No HER2 expression was observed in four endoscopic biopsies from the primary tumor. Tumors shrunk after S-1 with cisplatin treatment, and he underwent simple gastrectomy due to stenosis. Interestingly, HER2 diffusely overexpressed in the resected surgical specimen. His disease was stable with trastuzumab-containing therapy for 6.4 months. This case may suggest a selection of HER2-positive cells that were insensitive to the chemotherapy, and further study is needed for the change of intratumoral HER2 heterogeneity after chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bang YJ, Van Cutsem E, Feyereislova A et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomized controlled trial. Lancet 376(9742):687–697

    Article  CAS  Google Scholar 

  2. Boku N (2014) HER2-positive gastric cancer. Gastric Cancer 17(1):1–12

    Article  CAS  Google Scholar 

  3. National Comprehensive Cancer Network clinical practice guidelines in oncology (version 1.2020): Gastric cancer. NCCN. https://www.nccn.org/professionals/physician_gls/default.aspx

  4. Lee S, de Boer WB, Fermoyle S et al (2011) Human epidermal growth factor receptor 2 testing in gastric carcinoma: issues related to heterogeneity in biopsies and resections. Histopathology 59(5):832–840

    Article  Google Scholar 

  5. Kim MA, Lee HJ, Yang HK et al (2011) Heterogeneous amplification of ERBB2 in primary lesions is responsible for the discordant ERBB2 status of primary and metastatic lesions in gastric carcinoma. Histopathology 59(5):822–831

    Article  Google Scholar 

  6. Lee HE, Park KU, Yoo SB et al (2013) Clinical significance of intratumoral HER2 heterogeneity in gastric cancer. Eur J Cancer 49(6):1448–1457

    Article  CAS  Google Scholar 

  7. Yang J, Luo H, Li Y et al (2012) Intratumoral heterogeneity determines discordant results of diagnostic tests for human epidermal growth factor receptor (HER) 2 in gastric cancer specimens. Cell Biochem Biophys 62(1):221–228

    Article  CAS  Google Scholar 

  8. Pirrelli M, Caruso ML, Di Maggio M et al (2013) Are biopsy specimens predictive of HER2 status in gastric cancer patients? Dig Dis Sci 58(2):397–404

    CAS  PubMed  Google Scholar 

  9. Yano T, Doi T, Ohtsu A et al (2006) Comparison of HER2 gene amplification assessed by fluorescence in situ hybridization and HER2 protein expression assessed by immunohistochemistry in gastric cancer. Oncol Rep 15(1):65–71

    PubMed  Google Scholar 

  10. Yoshida H, Yamamoto N, Taniguchi H et al (2014) Comparison of HER2 status between surgically resected specimens and matched biopsy specimens of gastric intestinal type adenocarcinoma. Virchows Arch 465(2):145–154

    Article  CAS  Google Scholar 

  11. Wang T, Hsieh ET, Henry P et al (2014) Matched biopsy and resection specimens of gastric and gastroesophageal adenocarcinoma show high concordance in HER2 status. Hum Pathol 45(5):970–975

    Article  CAS  Google Scholar 

  12. Warneke VS, Behrens HM, Böger C et al (2013) Her2/neu testing in gastric cancer: evaluating the risk of sampling errors. Ann Oncol 24(3):725–733

    Article  CAS  Google Scholar 

  13. Tominaga N, Gotoda T, Hara M et al (2016) Five biopsy specimens from the proximal part of the tumor reliably determine HER2 protein expression status in gastric cancer. Gastric Cancer 19(2):553–560

    Article  CAS  Google Scholar 

  14. Huang SC, Ng KF, Lee SE et al (2016) HER2 testing in paired biopsy and excision specimens of gastric cancer: the reliability of the scoring system and the clinicopathological factors relevant to discordance. Gastric Cancer 19(1):176–182

    Article  CAS  Google Scholar 

  15. Japanese Gastric Cancer Association (2018) Japanese gastric cancer treatment guidelines 2018 (ver. 5). Kanehara & Co., Tokyo

    Google Scholar 

  16. Ross JS, Fletcher JA (1998) The HER-2/neu oncogene in breast cancer: prognostic factor, predictive factor, and target for therapy. Stem Cells 16(6):413–428

    Article  CAS  Google Scholar 

  17. Tsai CM, Chang KT, Perng RP et al (1993) Correlation of intrinsic chemoresistance of non-small-cell lung cancer cell lines with HER-2/neu gene expression but not with ras gene mutations. J Natl Cancer Inst 85(11):897–901

    Article  CAS  Google Scholar 

  18. Janjigian YY, Werner D, Pauligk C et al (2012) Prognosis of metastatic gastric and gastroesophageal junction cancer by HER2 status: a European and USA international collaborative analysis. Ann Oncol 23(10):2656–2662

    Article  CAS  Google Scholar 

  19. Wilke H, Muro K, Van Cutsem E et al (2014) Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial. Lancet Oncol 15(11):1224–1235

    Article  CAS  Google Scholar 

  20. Kang YK, Boku N, Satoh T et al (2017) Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 390(10111):2461–2471

    Article  CAS  Google Scholar 

  21. Kolostova K, Matkowski R, Gürlich R et al (2016) Detection and cultivation of circulating tumor cells in gastric cancer. Cytotechnology 68(4):1095–1102

    Article  CAS  Google Scholar 

  22. Mishima Y, Matsusaka S, Chin K et al (2017) Detection of HER2 amplification in circulating tumor cells of HER2-negative gastric cancer patients. Target Oncol 12(3):341–351

    Article  Google Scholar 

  23. Iqbal M, Roberts A, Starr J et al (2019) Feasibility and clinical value of circulating tumor DNA testing in patients with gastric adenocarcinomas. J Gastrointest Oncol 10(3):400–406

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Editage (https://www.editage.com) for English language editing.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Suguru Hirose, Toshikazu Moriwaki, Masamichi Yamaura, Daisuke Suganuma, Hiroki Tajima, Masashi Sato, Chiaki Enami, Takeshi Yamada, Yoshiyuki Yamamoto & Ichinosuke Hyodo

  2. Department of Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

    Noriaki Sakamoto

Authors
  1. Suguru Hirose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshikazu Moriwaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masamichi Yamaura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daisuke Suganuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiroki Tajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masashi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chiaki Enami
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takeshi Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshiyuki Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Noriaki Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ichinosuke Hyodo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Suguru Hirose.

Ethics declarations

Conflict of interest

IH received honorarium and research funding from Chugai and Taiho Pharma.

Ethical approval

The authors declare that this study conformed to the Declaration of Helsinki.

Informed consent

Informed consent was obtained from the patient for publication of his disease and clinical course.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hirose, S., Moriwaki, T., Yamaura, M. et al. A case of advanced gastric cancer showing HER2 positivity after chemotherapy. Int Canc Conf J 9, 112–115 (2020). https://doi.org/10.1007/s13691-020-00412-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13691-020-00412-8

Keywords

Search

Navigation