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The identification of a small but significant subset of patients still targetable with anti-HER2 inhibitors when affected by triple negative breast carcinoma

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Abstract

Purpose

Triple (ER-, PR-, HER2-) negative breast carcinoma lack targeted therapies, making this group of tumors difficult to treat. By definition, the lack of HER2 expression means a case scoring 0 or 1+ after immunophenotypical analysis and makes the patients avoiding therapeutical chances with anti-HER2 inhibitors. We sought to recruit from a group of triple negative breast carcinoma, patients eligible for effective personalized targeted therapy with anti-HER therapies on the basis of their HER2 gene status.

Methods

135 patients diagnosed with IHC triple negative breast carcinoma were studied. Whole tissue sections were used for in situ hybridization analysis.

Results

8/100 (8 %) of ductal-type triple negative breast carcinoma presented Her-2/neu gene amplification versus 2/35 (5.7 %) non-ductal triple negative breast carcinoma. Three cases showed a ratio 2.5. One case showed Her-2/neu heterogeneous gene amplification, ratio 2.3. The other six showed from 7 to 8 absolute Her-2/neu gene copy number. Two cases staged pT1c, and eight cases staged pT2. Eight cases graded G3 and two cases G2.

Conclusion

(1) Eight percentage of ductal and 5.7 % non-ductal-type triple negative breast carcinoma present Her-2/neu gene amplification, (2) the standard diagnostic flowchart “do not FISH in 0–1+ (HER2-) breast carcinoma” should be replaced by “do FISH in triple (ER-, PR-, HER2-) negative breast carcinoma,” to avoid loss of therapeutical chances in a cohort of such a patients, (3) we demonstrated the identification of a small but significant subset of patients targetable with anti-HER2 inhibitors, giving patients affected by (ex)triple negative breast carcinoma new personalized therapeutical chances.

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Acknowledgments

We thanks Dr. Andrea Remo MD (Mater Salutis Hospital, Legnago, Verona) and Dr. Daniela Reghellin (Cazzavillan Hospital, Arzignano, Vicenza) for providing few material cases.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Department of Pathology and Diagnostic, University of Verona, P.le Scuro n. 10, 37134, Verona, Italy

    Eleonora Brunello, Giuseppe Zamboni, Serena Pedron, Isabella Daniele, Erminia Manfrin, Serena Beccari, Franco Bonetti, Marco Chilosi, Guido Martignoni & Matteo Brunelli

  2. SacroCuore Hospital, Negrar, Verona, Italy

    Giuseppe Bogina, Giuseppe Zamboni & Marcella Marconi

  3. Medical Oncology dU, University of Verona, AOUI, Verona, Italy

    Emilio Bria, Jenny Furlanetto, Luisa Carbognin, Giampaolo Tortora & Annamaria Molino

  4. Royal Sussex County Hospital-Brighton and Sussex University Hospitals, NHS Trust, Brighton, UK

    Marco Vergine

  5. Department of Pathology, University College London, London, UK

    Merdol Ibrahim

  6. UKNeqas, United Kingdom National External Quality Assessment Service, London, UK

    Merdol Ibrahim & Keith Miller

  7. Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Ireland

    Bharat Jasani

Authors
  1. Eleonora Brunello
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  2. Giuseppe Bogina
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  3. Emilio Bria
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  4. Marco Vergine
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  5. Giuseppe Zamboni
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  6. Serena Pedron
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  7. Isabella Daniele
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  8. Jenny Furlanetto
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  9. Luisa Carbognin
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  10. Marcella Marconi
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  11. Erminia Manfrin
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  12. Merdol Ibrahim
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  13. Keith Miller
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  14. Giampaolo Tortora
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  15. Annamaria Molino
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  16. Bharat Jasani
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  17. Serena Beccari
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  18. Franco Bonetti
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  19. Marco Chilosi
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  20. Guido Martignoni
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  21. Matteo Brunelli
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Corresponding author

Correspondence to Matteo Brunelli.

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Brunello, E., Bogina, G., Bria, E. et al. The identification of a small but significant subset of patients still targetable with anti-HER2 inhibitors when affected by triple negative breast carcinoma. J Cancer Res Clin Oncol 139, 1563–1568 (2013). https://doi.org/10.1007/s00432-013-1479-0

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  • DOI: https://doi.org/10.1007/s00432-013-1479-0

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