Researchers led by Professor Florian Lordick, Director of the University Cancer Centre Leipzig (UCCL), were part of a Germany-wide consortium that investigated how HER2-targeted drug treatment can be optimised in gastric cancer. For this purpose, data from 548 patients from 35 treatment centres was collected and tumour samples examined in laboratories at the central pathology institute at Leipzig University. The five-year study makes an important contribution to the establishment of precision therapy using drugs in gastric carcinoma.
Targeted cancer drugs open up opportunities for better and longer survival. In metastatic gastric cancer, this therapy is possible with the approved drug trastuzumab. For treatment, the expression of the “human epidermal growth factor receptor” (HER2) must be detected in each patient. HER2 receptors are binding sites for growth factors on the cell surface of tumour cells. The more of these binding sites there are, the greater the likelihood that signals will be transmitted to the cell nucleus, causing tumour cells to grow faster and live longer. These HER2 receptors are increased in about 20 per cent of all gastric carcinomas.
On closer examination of the tumour samples at Leipzig University Hospital, the experts found that in one in four patients it was not possible to confirm the results of HER2 determination from specialist clinics and hospitals in Germany. This is due to the different expression of numerous tumour characteristics in gastric cancer, including the HER2 receptor. The good news of the study: with accurate diagnosis of HER2 status, patients received targeted drug treatment that really benefited them. As a result, patients saw significant improvement in tumour response but also increased survival and quality of life. This precise diagnosis does not require expensive additional technologies. It was implemented using established investigation methods in gastric cancer. .
Individual diagnosis for targeted cancer treatment
Professor Lordick, head of the research programme, which was funded by the German Federal Ministry of Education and Research, said: “The different expression of tumour characteristics often stands in the way of effective treatment in gastric cancer. A precise description of HER2 expression within each individual case is required in order to select patients for targeted treatment. We are moving away from therapy that is suitable for all patients towards personalised, custom-fit cancer treatment. This is dependent on differentiated molecular diagnostics in each individual case.”
The study specifies which patients may benefit from HER2 therapy. The oncologist Lordick concludes that detailed and quality-controlled reports of HER2 test results should be made available in practice to identify those patients with gastric cancer who would significantly benefit from HER2-targeted therapy.
Original title of the publication in “Journal of Clinical Oncology”:
HER2 Expression, Test Deviations, and Their Impact on Survival in Metastatic Gastric Cancer: Results From the Prospective Multicenter VARIANZ Study, doi/full/10.1200/JCO.20.02761