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  • Incidence, clinicopathologi...
    Nakayama, I.; Takahari, D.; Chin, K.; Wakatsuki, T.; Takamatsu, M.; Yamamoto, N.; Ogura, M.; Ooki, A.; Fukuda, K.; Osumi, H.; Fukuoka, S.; Shinozaki, E.; Yamaguchi, K.

    ESMO open, 08/2023, Letnik: 8, Številka: 4
    Journal Article

    According to the DESTINY-Breast04 trial, treating patients with breast cancer and low human epidermal growth factor receptor 2 expressions (HER2-low) varies from that of those with no HER2 expression. However, it is interesting to know if HER2-low indicates for anti-HER2 therapy in the gastric or gastroesophageal junction (G/GEJ) adenocarcinoma. Hence we conducted this study to assess the incidence, clinicopathological features, and treatment outcomes of patients with HER2-low G/GEJ adenocarcinoma. This was a single-center, retrospective observational study. Patients with previously untreated G/GEJ adenocarcinoma were classified based on their HER2 status using immunohistochemistry (IHC) with or without in situ hybridization (ISH) as follows: HER2 negative (IHC 0), HER2-low (IHC 1+ or 2+/ISH–), and HER2-positive (IHC2+/ISH+ or 3+). In total, 734 patients with G/GEJ adenocarcinoma were divided into three groups (HER2-negative, n = 410; HER2-low, n = 154, and HER2-positive, n = 170). The intestinal-type histology, peritoneal metastasis, and higher serum carcinoembryonic antigen (CEA) levels differed significantly among patients with negative, low, and positive HER2 statuses: intestinal-type histology (21.0%, 44.2%, and 59.8%, respectively), peritoneal metastasis (56.3%, 44.8%, and 21.8%, respectively), and higher serum CEA level (32.2%, 41.6%, and 56.5%, respectively). Improved survival was observed in the HER2-positive group than in the HER2-negative G/GEJ adenocarcinoma group hazard ratio (HR) = 0.73, 95% confidence interval (CI) 0.59-0.89; P = 0.002. However, the prognoses of the HER2-low and HER2-negative groups were similar (HR = 1.01, 95% CI 0.82-1.23; P = 0.843). Patients with HER2-low G/GEJ adenocarcinoma exhibited intermediate and distinct characteristics than those in the HER2-negative group. Similarly, the HER2-low group’s prognosis was worse than that of the HER2-positive group. Therefore developing novel therapeutic strategies targeting HER2-low G/GEJ adenocarcinoma is required. •HER2-low G/GEJ adenocarcinoma had intermediate clinicopathological features than the HER2-negative and HER2-positive groups.•The HER2-low group’s prognosis was worse than that of the HER2-positive group but similar to that of the HER2-negative group.•Personalized targeted therapy for the right target is required to improve the prognosis of these patients further.