There is growing weight of evidence for the role of human epidermal growth factor receptor in predicting outcome of breast cancer, British scientists report today.
The predictive value of the protein, known as HER2, for outcomes of ductal carcinoma in situ – the pre-invasive stage of breast cancer – was explored by Dr Mangesh Thorat, from Queen Mary University of London, UK, and his team.
They tested tissue samples collected from participants in the UK/ANZ DCIS trial, which investigates the role of tamoxifen, radiotherapy or both as adjuvant treatment in ductal carcinoma in situ. The team measured HER2 expression using immunohistochemistry.
Findings are published today in Clinical Cancer Research. They show a clear role for HER2 in outcome prediction. HER2 overexpression was linked to an almost three-fold higher rate of in situ recurrence.
In addition, patients with tumours expressing HER2 appear to benefit more from adjuvant radiotherapy. The authors call for HER2 testing to be widely used in ductal carcinoma in situ to develop better personalised treatment.
Dr Thorat said: “Prior studies investigating the role of HER2 in ductal carcinoma in situ were riddled with problems such as bias and confounding. This is the first study to use randomised trial data to overcome these limitations, and to produce robust results that we can rely on for making changes to clinical practice.
"These findings support the use of HER2 status to personalise treatment decisions including the use of adjuvant radiotherapy. They also make a strong case for the routine evaluation of HER2 expression in ductal carcinoma in situ.”
Thorat, M. A, et al. Prognostic and predictive value of HER2 expression in ductal carcinoma in situ: Results from the UK/ANZ DCIS randomized trial. Clinical Cancer Research doi: 10.1158/1078-0432.CCR-21-1239
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