lunes, 6 de marzo de 2017

Utility of comprehensive genomic sequencing for detecting HER2-positive colorectal cancer. - PubMed - NCBI

2017 Feb 21. pii: S0046-8177(17)30051-5. doi: 10.1016/j.humpath.2017.02.004. [Epub ahead of print]

Utility of comprehensive genomic sequencing for detecting HER2-positive colorectal cancer.

Shimada Y1, Yagi R2, Kameyama H2, Nagahashi M2, Ichikawa H2, Tajima Y2, Okamura T2, Nakano M2, Nakano M2, Sato Y3, Matsuzawa T3, Sakata J2, Kobayashi T2, Nogami H4, Maruyama S4, Takii Y4, Kawasaki T5, Homma KI5, Izutsu H6, Kodama K6, Ring JE7, Protopopov A7, Lyle S8, Okuda S9, Akazawa K10, Wakai T2.

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Abstract

HER2-targeted therapy is considered effective for KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer (CRC). In general, HER2 status is determined by the use of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Comprehensive genomic sequencing (CGS) enables the detection of gene mutations and copy number alterations including KRAS mutation and HER2 amplification; however, little is known about the utility of CGS for detecting HER2-positive CRC. To assess its utility, we retrospectively investigated 201 patients with stage I-IV CRC. The HER2 status of the primary site was assessed using IHC and FISH, and HER2 amplification of the primary site was also assessed using CGS, and the findings of these approaches were compared in each patient. CGS successfully detected alterations in 415 genes including KRAS codon 12/13 mutation and HER2 amplification. Fifty-nine (29%) patients had a KRAS codon 12/13 mutation. Ten (5%) patients were diagnosed as HER2-positive because of HER2 IHC 3+, and the same 10 (5%) patients had HER2 amplification evaluated using CGS. The results of HER2 status and HER2 amplification were completely identical in all 201 patients (P < 0.001). Nine of the 10 HER2-positive patients were KRAS 12/13 wild-type and were considered possible candidates for HER2-targeted therapy. CGS has the same utility as IHC and FISH for detecting HER2-positive patients who are candidates for HER2-targeted therapy, and facilitates precision medicine and tailor-made treatment.