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HER2 as Biomarker for Endometrial Cancer

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Book cover Biomarkers in Cancer

Abstract

HER2 or ErbB2 is a member of the epidermal growth factor family and is a well-established biomarker that is overexpressed in a wide variety of tumor types including breast, ovarian, gastric, colorectal, pancreatic, and endometrial cancers. HER2 regulates signaling through several pathways (Ras/Raf/mitogen-activated protein kinase and phosphatidylinositol-3 kinase/protein kinase-B/mammalian target of rapamycin pathways) associated with cell survival and proliferation. In endometrial cancer there have been several studies linking the overexpression of HER2 and/or the amplification of the c-erbB2 gene with chemoresistance and overall poor survival. Immunotherapy with monoclonal antibodies targeting HER2 as well as the use of novel tyrosine kinase inhibitors targeting the erbB pathway may hold promise for patients harboring these biologically aggressive endometrial neoplasms.

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Abbreviations

ADCC:

Antibody-Dependent Cellular Cytotoxicity

CDC:

Complement-Dependent Cytotoxicity

CISH:

Chromogenic In Situ Hybridization

FISH:

Fluorescence In Situ Hybridization

HER2:

Human Epidermal Growth Factor Receptor

IHC:

Immunohistochemistry

mCRPs:

Membrane Complement Regulatory Proteins

NK:

Natural Killer Cells

PBL:

Peripheral Blood Lymphocytes

SISH:

Silver-Enhanced In Situ Hybridization

Tc :

Cytotoxic T Cells

Tregs :

Regulatory T Cells

USC:

Uterine Serous Carcinoma

References

  • Andre F, Campone M, O’Regan R, Manlius C, Massacesi C, Sahmoud T, Mukhopadhyay P, Soria JC, Naughton M, Hurvitz SA. Phase I study of everolimus plus weekly paclitaxel and trastuzumab in patients with metastatic breast cancer pretreated with trastuzumab. J Clin Oncol. 2010;28(34):5110–5.

    Article  CAS  PubMed  Google Scholar 

  • Barok M, Tanner M, Koninki K, Isola J. Trastuzumab-DM1 causes tumour growth inhibition by mitotic catastrophe in trastuzumab-resistant breast cancer cells in vivo. Breast Cancer Res. 2011;13(2):R46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bellone S, Roque D, Cocco E, Gasparrini S, Bortolomai I, Buza N, Abu-Khalaf M, Silasi DA, Ratner E, Azodi M, Schwartz PE, Rutherford TJ, Pecorelli S, Santin AD. Downregulation of membrane complement inhibitors CD55 and CD59 by siRNA sensitises uterine serous carcinoma overexpressing Her2/neu to complement and antibody-dependent cell cytotoxicity in vitro: implications for trastuzumab-based immunotherapy. Br J Cancer. 2012;106(9):1543–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Benevolo M, Vocaturo A, Novelli F, Mariani L, Vocaturo G, Cianciulli AM, Marandino F, Perrone-Donnorso R, Giannarelli D, Natali PG, Mottolese M. Prognostic value of HER2 and progesterone receptor expression in endometrial carcinoma with positive peritoneal washing. Anticancer Res. 2007;27(4C):2839–44.

    CAS  PubMed  Google Scholar 

  • Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10–7.

    Article  CAS  PubMed  Google Scholar 

  • Boruta 2nd DM, Gehrig PA, Fader AN, Olawaiye AB. Management of women with uterine papillary serous cancer: a Society of Gynecologic Oncology (SGO) review. Gynecol Oncol. 2009;115(1):142–53.

    Article  PubMed  Google Scholar 

  • Boyman O, Krieg C, Letourneau S, Webster K, Surh CD, Sprent J. Selectively expanding subsets of T cells in mice by injection of interleukin-2/antibody complexes: implications for transplantation tolerance. Transplant Proc. 2012;44(4):1032–4.

    Article  CAS  PubMed  Google Scholar 

  • Buza N, Hui P. Marked heterogeneity of HER2/NEU gene amplification in endometrial serous carcinoma. Genes Chromosomes Cancer. 2013;52:1178–86.

    Article  CAS  PubMed  Google Scholar 

  • Buza N, English DP, Santin AD, Hui P. Toward standard HER2 testing of endometrial serous carcinoma: 4-year experience at a large academic center and recommendations for clinical practice. Mod Pathol. 2013;26:1605–12.

    Article  CAS  PubMed  Google Scholar 

  • Buza N, Roque DM, Santin AD. HER2/neu in endometrial cancer: a promising therapeutic target with diagnostic challenges. Arch Pathol Lab Med. 2014;138(3):343–50.

    Article  PubMed  Google Scholar 

  • Carter P. Improving the efficacy of antibody-based cancer therapies. Nat Rev Cancer. 2001;1(2):118–29.

    Article  CAS  PubMed  Google Scholar 

  • Cayre A, Mishellany F, Lagarde N, Penault-Llorca F. Comparison of different commercial kits for HER2 testing in breast cancer: looking for the accurate cutoff for amplification. Breast Cancer Res. 2007;9(5):R64.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cheng Y, Li H, Ren X, Niu T, Hait WN, Yang J. Cytoprotective effect of the elongation factor-2 kinase-mediated autophagy in breast cancer cells subjected to growth factor inhibition. PLoS One. 2010;5(3):e9715.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cheng X, Yang G, Schmeler KM, Coleman RL, Tu X, Liu J, Kavanagh JJ. Recurrence patterns and prognosis of endometrial stromal sarcoma and the potential of tyrosine kinase-inhibiting therapy. Gynecol Oncol. 2011;121(2):323–7.

    Article  CAS  PubMed  Google Scholar 

  • Clynes RA, Towers TL, Presta LG, Ravetch JV. Inhibitory Fc receptors modulate in vivo cytotoxicity against tumor targets. Nat Med. 2000;6(4):443–6.

    Article  CAS  PubMed  Google Scholar 

  • Diaz-Montes TP, Ji H, Smith Sehdev AE, Zahurak ML, Kurman RJ, Armstrong DK, Bristow RE. Clinical significance of Her-2/neu overexpression in uterine serous carcinoma. Gynecol Oncol. 2006;100(1):139–44.

    Article  CAS  PubMed  Google Scholar 

  • Dua R, Zhang J, Nhonthachit P, Penuel E, Petropoulos C, Parry G. EGFR over-expression and activation in high HER2, ER negative breast cancer cell line induces trastuzumab resistance. Breast Cancer Res Treat. 2010;122(3):685–97.

    Article  CAS  PubMed  Google Scholar 

  • El-Sahwi K, Bellone S, Cocco E, Cargnelutti M, Casagrande F, Bellone M, Abu-Khalaf M, Buza N, Tavassoli FA, Hui P, Silasi DA, Azodi M, Schwartz PE, Rutherford TJ, Pecorelli S, Santin AD. In vitro activity of pertuzumab in combination with trastuzumab in uterine serous papillary adenocarcinoma. Br J Cancer. 2010;102(1):134–43.

    Article  CAS  PubMed  Google Scholar 

  • Faratian D, Zweemer AJ, Nagumo Y, Sims AH, Muir M, Dodds M, Mullen P, Um I, Kay C, Hasmann M, Harrison DJ, Langdon SP. Trastuzumab and pertuzumab produce changes in morphology and estrogen receptor signaling in ovarian cancer xenografts revealing new treatment strategies. Clin Cancer Res. 2011;17(13):4451–61.

    Article  CAS  PubMed  Google Scholar 

  • Felix AS, Weissfeld JL, Stone RA, Bowser R, Chivukula M, Edwards RP, Linkov F. Factors associated with Type I and Type II endometrial cancer. Cancer Causes Control. 2010;21(11):1851–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fleming GF, Sill MW, Darcy KM, McMeekin DS, Thigpen JT, Adler LM, Berek JS, Chapman JA, DiSilvestro PA, Horowitz IR, Fiorica JV. Phase II trial of trastuzumab in women with advanced or recurrent, HER2-positive endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2010;116(1):15–20.

    Article  CAS  PubMed  Google Scholar 

  • Gelderman KA, Lam S, Gorter A. Inhibiting complement regulators in cancer immunotherapy with bispecific mAbs. Expert Opin Biol Ther. 2005;5(12):1593–601.

    Article  CAS  PubMed  Google Scholar 

  • Gennari R, Menard S, Fagnoni F, Ponchio L, Scelsi M, Tagliabue E, Castiglioni F, Villani L, Magalotti C, Gibelli N, Oliviero B, Ballardini B, Da Prada G, Zambelli A, Costa A. Pilot study of the mechanism of action of preoperative trastuzumab in patients with primary operable breast tumors overexpressing HER2. Clin Cancer Res. 2004;10(17):5650–5.

    Article  CAS  PubMed  Google Scholar 

  • Grundker C, Gunthert AR, Emons G. Hormonal heterogeneity of endometrial cancer. Adv Exp Med Biol. 2008;630:166–88.

    Article  PubMed  Google Scholar 

  • Grushko TA, Filiaci VL, Mundt AJ, Ridderstrale K, Olopade OI, Fleming GF. An exploratory analysis of HER-2 amplification and overexpression in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2008;108(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  • Hecht JL, Mutter GL. Molecular and pathologic aspects of endometrial carcinogenesis. J Clin Oncol. 2006;24(29):4783–91.

    Article  CAS  PubMed  Google Scholar 

  • Jung M, Koo JS, Moon YW, Park BW, Kim SI, Park S, Lee SH, Hong S, Rha SY, Chung HC, Kim JH, Sohn J. Overexpression of class III beta tubulin and amplified HER2 gene predict good response to paclitaxel and trastuzumab therapy. PLoS One. 2012;7(9):e45127.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kitao K, Yoshida S, Kennedy S, Takemura N, Sugimoto M, Deguchi M, Ohara N, Maruo T. Epidermal growth factor receptor and human epidermal growth factor receptor 2 gene polymorphisms in endometrial cancer in a Japanese population. Reprod Sci. 2007;14(4):349–57.

    Article  CAS  PubMed  Google Scholar 

  • Kohrt HE, Houot R, Weiskopf K, Goldstein MJ, Scheeren F, Czerwinski D, Colevas AD, Weng WK, Clarke MF, Carlson RW, Stockdale FE, Mollick JA, Chen L, Levy R. Stimulation of natural killer cells with a CD137-specific antibody enhances trastuzumab efficacy in xenotransplant models of breast cancer. J Clin Invest. 2012;122(3):1066–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kulkarni S, Reddy KB, Esteva FJ, Moore HC, Budd GT, Tubbs RR. Calpain regulates sensitivity to trastuzumab and survival in HER2-positive breast cancer. Oncogene. 2010;29(9):1339–50.

    Article  CAS  PubMed  Google Scholar 

  • Lang SA, Hackl C, Moser C, Fichtner-Feigl S, Koehl GE, Schlitt HJ, Geissler EK, Stoeltzing O. Implication of RICTOR in the mTOR inhibitor-mediated induction of insulin-like growth factor-I receptor (IGF-IR) and human epidermal growth factor receptor-2 (Her2) expression in gastrointestinal cancer cells. Biochim Biophys Acta. 2010;1803(4):435–42.

    Article  CAS  PubMed  Google Scholar 

  • Lax SF, Pizer ES, Ronnett BM, Kurman RJ. Comparison of estrogen and progesterone receptor, Ki-67, and p53 immunoreactivity in uterine endometrioid carcinoma and endometrioid carcinoma with squamous, mucinous, secretory, and ciliated cell differentiation. Hum Pathol. 1998;29(9):924–31.

    Article  CAS  PubMed  Google Scholar 

  • Mamidi S, Cinci M, Hasmann M, Fehring V, Kirschfink M. Lipoplex mediated silencing of membrane regulators (CD46, CD55 and CD59) enhances complement-dependent anti-tumor activity of trastuzumab and pertuzumab. Mol Oncol. 2013;7(3):580–94.

    Article  CAS  PubMed  Google Scholar 

  • Morrison C, Zanagnolo V, Ramirez N, Cohn DE, Kelbick N, Copeland L, Maxwell GL, Fowler JM. HER-2 is an independent prognostic factor in endometrial cancer: association with outcome in a large cohort of surgically staged patients. J Clin Oncol. 2006;24(15):2376–85.

    Article  CAS  PubMed  Google Scholar 

  • Musolino A, Naldi N, Bortesi B, Pezzuolo D, Capelletti M, Missale G, Laccabue D, Zerbini A, Camisa R, Bisagni G, Neri TM, Ardizzoni A. Immunoglobulin G fragment C receptor polymorphisms and clinical efficacy of trastuzumab-based therapy in patients with HER-2/neu-positive metastatic breast cancer. J Clin Oncol. 2008;26(11):1789–96.

    Article  CAS  PubMed  Google Scholar 

  • NCT01367002., N. C. T. E. o. c. p. w. o. w. t. H. i. u. s. c. h. c. g. c. s. https://clinicaltrials.gov/ct2/show/NCT01367002.

  • Neckers L. Heat shock protein 90: the cancer chaperone. J Biosci. 2007;32(3):517–30.

    Article  CAS  PubMed  Google Scholar 

  • Noguchi S. Predictive factors for response to docetaxel in human breast cancers. Cancer Sci. 2006;97(9):813–20.

    Article  CAS  PubMed  Google Scholar 

  • Palyi-Krekk Z, Barok M, Isola J, Tammi M, Szollosi J, Nagy P. Hyaluronan-induced masking of ErbB2 and CD44-enhanced trastuzumab internalisation in trastuzumab resistant breast cancer. Eur J Cancer. 2007;43(16):2423–33.

    Article  CAS  PubMed  Google Scholar 

  • Penault-Llorca F, Bilous M, Dowsett M, Hanna W, Osamura RY, Ruschoff J, van de Vijver M. Emerging technologies for assessing HER2 amplification. Am J Clin Pathol. 2009;132(4):539–48.

    Article  CAS  PubMed  Google Scholar 

  • Pupa SM, Menard S, Morelli D, Pozzi B, De Palo G, Colnaghi MI. The extracellular domain of the c-erbB-2 oncoprotein is released from tumor cells by proteolytic cleavage. Oncogene. 1993;8(11):2917–23.

    CAS  PubMed  Google Scholar 

  • Ritter CA, Perez-Torres M, Rinehart C, Guix M, Dugger T, Engelman JA, Arteaga CL. Human breast cancer cells selected for resistance to trastuzumab in vivo overexpress epidermal growth factor receptor and ErbB ligands and remain dependent on the ErbB receptor network. Clin Cancer Res. 2007;13(16):4909–19.

    Article  CAS  PubMed  Google Scholar 

  • Rolitsky CD, Theil KS, McGaughy VR, Copeland LJ, Niemann TH. HER-2/neu amplification and overexpression in endometrial carcinoma. Int J Gynecol Pathol. 1999;18(2):138–43.

    Article  CAS  PubMed  Google Scholar 

  • Saffari B, Jones LA, el-Naggar A, Felix JC, George J, Press MF. Amplification and overexpression of HER-2/neu (c-erbB2) in endometrial cancers: correlation with overall survival. Cancer Res. 1995;55(23):5693–8.

    CAS  PubMed  Google Scholar 

  • Santin AD, Bellone S, Gokden M, Palmieri M, Dunn D, Agha J, Roman JJ, Hutchins L, Pecorelli S, O’Brien T, Cannon MJ, Parham GP. Overexpression of HER-2/neu in uterine serous papillary cancer. Clin Cancer Res. 2002;8(5):1271–9.

    CAS  PubMed  Google Scholar 

  • Santin AD, Bellone S, Siegel ER, Palmieri M, Thomas M, Cannon MJ, Kay HH, Roman JJ, Burnett A, Pecorelli S. Racial differences in the overexpression of epidermal growth factor type II receptor (HER2/neu): a major prognostic indicator in uterine serous papillary cancer. Am J Obstet Gynecol. 2005a;192(3):813–8.

    Article  CAS  PubMed  Google Scholar 

  • Santin AD, Bellone S, Van Stedum S, Bushen W, De Las Casas LE, Korourian S, Tian E, Roman JJ, Burnett A, Pecorelli S. Determination of HER2/neu status in uterine serous papillary carcinoma: comparative analysis of immunohistochemistry and fluorescence in situ hybridization. Gynecol Oncol. 2005b;98(1):24–30.

    Article  CAS  PubMed  Google Scholar 

  • Santin AD, Bellone S, Roman JJ, McKenney JK, Pecorelli S. Trastuzumab treatment in patients with advanced or recurrent endometrial carcinoma overexpressing HER2/neu. Int J Gynaecol Obstet. 2008;102(2):128–31.

    Article  CAS  PubMed  Google Scholar 

  • Sawada M, Tsuda H, Kimura M, Okamoto S, Kita T, Kasamatsu T, Yamada T, Kikuchi Y, Honjo H, Matsubara O. Different expression patterns of KIT, EGFR, and HER-2 (c-erbB-2) oncoproteins between epithelial and mesenchymal components in uterine carcinosarcoma. Cancer Sci. 2003;94(11):986–91.

    Article  CAS  PubMed  Google Scholar 

  • Sherman ME. Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Pathol. 2000;13(3):295–308.

    Article  CAS  PubMed  Google Scholar 

  • Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29.

    Article  PubMed  Google Scholar 

  • Spiridon CI, Guinn S, Vitetta ES. A comparison of the in vitro and in vivo activities of IgG and F(ab’)2 fragments of a mixture of three monoclonal anti-Her-2 antibodies. Clin Cancer Res. 2004;10(10):3542–51.

    Article  CAS  PubMed  Google Scholar 

  • Togami S, Sasajima Y, Oi T, Ishikawa M, Onda T, Ikeda S, Kato T, Tsuda H, Kasamatsu T. Clinicopathological and prognostic impact of human epidermal growth factor receptor type 2 (HER2) and hormone receptor expression in uterine papillary serous carcinoma. Cancer Sci. 2012;103(5):926–32.

    Article  CAS  PubMed  Google Scholar 

  • Wilken JA, Webster KT, Maihle NJ. Trastuzumab sensitizes ovarian cancer cells to EGFR-targeted therapeutics. J Ovarian Res. 2010;3:7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilson TO. Evaluation of unfavorable histologic subtypes in endometrial adenocarcinoma. Am J Obstet Gynecol. 1990;162(2):418–26.

    Article  CAS  PubMed  Google Scholar 

  • Wolff AC, Hammond ME, Hicks DG, Dowsett M, McShane LM, Allison KH, Allred DC, Bartlett JM, Bilous M, Fitzgibbons P, Hanna W, Jenkins RB, Mangu PB, Paik S, Perez EA, Press MF, Spears PA, Vance GH, Viale G, Hayes DF. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Update. J Clin Oncol. 2013;31(31):3997–4013.

    Article  PubMed  Google Scholar 

  • Wright JD, Fiorelli J, Schiff PB, Burke WM, Kansler AL, Cohen CJ, et al. Racial disparities for uterine corpus tumors: changes in clinical characteristics and treatment over time. Cancer. 2009;115(6):1276–85.

    Article  PubMed  Google Scholar 

  • Xu M, Schwartz P, Rutherford T, Azodi M, Santin A, Silasi D, Martel M, Hui P. HER-2/neu receptor gene status in endometrial carcinomas: a tissue microarray study. Histopathology. 2010;56(2):269–73.

    Article  PubMed  Google Scholar 

  • Yoon JH, Yoo SC, Kim WY, Chang SJ, Chang KH, Ryu HS. Para-aortic lymphadenectomy in the management of preoperative grade 1 endometrial cancer confined to the uterine corpus. Ann Surg Oncol. 2010;17(12):3234–40.

    Article  PubMed  Google Scholar 

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Correspondence to Alessandro D. Santin .

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English, D.P., Roque, D.M., Buza, N., Santin, A.D. (2015). HER2 as Biomarker for Endometrial Cancer . In: Preedy, V., Patel, V. (eds) Biomarkers in Cancer. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7681-4_26

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