A case of metastatic breast cancer with outgrowth of HER2-negative cells after eradication of HER2-positive cells by humanized Anti-HER2 monoclonal antibody (trastuzumab) combined with docetaxel
- 11 March 2004
- journal article
- case report
- Published by Elsevier BV in Human Pathology
- Vol. 35 (3), 379-381
- https://doi.org/10.1016/j.humpath.2003.05.003
Abstract
A 38-year-old woman with cancer of the left breast underwent a modified radical mastectomy with lymph node dissection. Twenty-one months later, massive liver metastases and pleural carcinomatosis occurred. The liver metastases responded completely to chemotherapy with trastuzumab combined with docetaxel, but the pleural carcinomatosis was refractory to the therapy. Fluorescence in situ hybridization showed that both the primary tumor and the metastatic tumors of the lymph nodes were composed of HER2 amplification-positive and HER2 amplification-negative cancer cells. This analysis also detected a single cell with HER2 amplification in the pleural effusion that was taken at the completion of the chemotherapy, but four follow-up tests showed no amplified cells. It is speculated that in the liver metastases, the trastuzumab was cytotoxic to both HER2-amplified and nonamplified cancer cells and may have acted through its antiangiogenic effect. However, in the pleural effusion, the effect of trastuzumab was more specific to HER2-amplified cells and caused outgrowth of cancer cells lacking expression of HER2 receptors.Keywords
This publication has 6 references indexed in Scilit:
- Herceptin acts as an anti-angiogenic cocktailNature, 2002
- Protein overexpression and gene amplification of c-erbB-2 in breast carcinomas: A comparative study of immunohistochemistry and fluorescence in situ hybridization of formalin-fixed, paraffin-embedded tissuesHuman Pathology, 2002
- Patterns of HER-2/neu Amplification and Overexpression in Primary and Metastatic Breast CancerJNCI Journal of the National Cancer Institute, 2001
- Are Patterns of HER-2/neu Amplification and Expression Among Primary Tumors and Regional Metastases Indicative of Those in Distant Metastases and Predictive of Herceptin Response?JNCI Journal of the National Cancer Institute, 2001
- In vitro and in vivo anti-tumour effects of a humanised monoclonal antibody against c-erbB-2 productBritish Journal of Cancer, 1996
- Chemotherapy for carcinomatous peritonitis and pleuritis with MMC-CH, mitomycin C adsorbed on activated carbon particles. Clinical trialsCancer, 1987