PDF(Pubmed)
Abstract：
UNASSIGNED: Serous endometrial cancers (ECs) are an aggressive histotype of ECs which are disproportionately responsible for 40% of cancer-specific mortality rates despite constituting only 5-10% of all uterine cancers in incidence. In recent times, it has become increasingly evident that about 20-40% of uterine serous cancers (USCs) have molecular alterations in ERBB2 pathway with human epidermal growth factor receptor 2 (HER2/neu) amplification or overexpression. We summarise the evidence on genetic and molecular alterations in HER2/neu pathway in USC with a focus on testing criteria, targeting agents and resistance mechanisms.
UNASSIGNED: We conducted a database search of PubMed/Medline up to 28th February 2023 for articles published in the English language using pre-defined search terms. One hundred and seventy-one relevant articles were subsequently reviewed for eligibility and inclusion in the review.
UNASSIGNED: The Cancer Genome Atlas (TCGA) classification is a significant development in the molecular profiling of ECs with a positive impact on the treatment of these tumors including USCs. Testing criteria for HER2/neu in USC with immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) has evolved in more than a decade with progress made towards EC specific testing guidelines. The findings of a recent phase III study have led to the development of practice changing guidelines towards improving patient outcomes.
UNASSIGNED: Molecular aberration in the HER2/neu pathway contributes to the aggressive behaviour of USC. Considering the clinical benefit conferred by HER2/neu targeted therapy, HER2/neu testing is recommended for all cases of serous EC in advanced and recurrent settings. Trastuzumab in combination with platinum and taxanes based chemotherapy is the recommended treatment option for patients with advanced or recurrent serous cancers who test positive to HER2/neu. Clinical trials on targeted therapy are ongoing and future research should focus on selection of patients who will derive the most benefit from such therapy.
UNASSIGNED: We conducted a database search of PubMed/Medline up to 28th February 2023 for articles published in the English language using pre-defined search terms. One hundred and seventy-one relevant articles were subsequently reviewed for eligibility and inclusion in the review.
UNASSIGNED: The Cancer Genome Atlas (TCGA) classification is a significant development in the molecular profiling of ECs with a positive impact on the treatment of these tumors including USCs. Testing criteria for HER2/neu in USC with immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) has evolved in more than a decade with progress made towards EC specific testing guidelines. The findings of a recent phase III study have led to the development of practice changing guidelines towards improving patient outcomes.
UNASSIGNED: Molecular aberration in the HER2/neu pathway contributes to the aggressive behaviour of USC. Considering the clinical benefit conferred by HER2/neu targeted therapy, HER2/neu testing is recommended for all cases of serous EC in advanced and recurrent settings. Trastuzumab in combination with platinum and taxanes based chemotherapy is the recommended treatment option for patients with advanced or recurrent serous cancers who test positive to HER2/neu. Clinical trials on targeted therapy are ongoing and future research should focus on selection of patients who will derive the most benefit from such therapy.
摘要：
浆液性子宫内膜癌(ECs)是一种侵袭性组织型ECs,尽管仅占所有子宫癌发病率的5-10%,但其占癌症特异性死亡率的40%不成比例。最近,越来越明显的是,约20-40%的子宫浆液性癌(USCs)在人表皮生长因子受体2(HER2/neu)扩增或过表达的ERBB2通路中存在分子改变.我们总结了南加州大学HER2/neu通路遗传和分子改变的证据，重点是测试标准。靶向剂和抗性机制。
我们在2023年2月28日之前对PubMed/Medline进行了数据库搜索，以使用预定义的搜索词以英语发表的文章。随后审查了一百七十一条相关文章的资格和纳入审查的资格。
■癌症基因组图谱（TCGA）分类是EC分子谱分析的重要发展，对包括USC在内的这些肿瘤的治疗具有积极影响。在USC中使用免疫组织化学（IHC）和荧光原位杂交（FISH）测试HER2/neu的标准已经发展了十多年，并在EC特定测试指南方面取得了进展。最近的一项III期研究的结果导致了实践改变指南的发展，以改善患者的预后。
■HER2/neu途径中的分子畸变有助于USC的攻击行为。考虑到HER2/neu靶向治疗的临床获益，HER2/neu检测建议用于晚期和复发性浆液性EC的所有病例。曲妥珠单抗与基于铂和紫杉烷的化疗联合是HER2/neu检测阳性的晚期或复发性浆液性癌症患者的推荐治疗选择。关于靶向治疗的临床试验正在进行中，未来的研究应该集中在选择将从这种治疗中获得最大益处的患者上。
我们在2023年2月28日之前对PubMed/Medline进行了数据库搜索，以使用预定义的搜索词以英语发表的文章。随后审查了一百七十一条相关文章的资格和纳入审查的资格。
■癌症基因组图谱（TCGA）分类是EC分子谱分析的重要发展，对包括USC在内的这些肿瘤的治疗具有积极影响。在USC中使用免疫组织化学（IHC）和荧光原位杂交（FISH）测试HER2/neu的标准已经发展了十多年，并在EC特定测试指南方面取得了进展。最近的一项III期研究的结果导致了实践改变指南的发展，以改善患者的预后。
■HER2/neu途径中的分子畸变有助于USC的攻击行为。考虑到HER2/neu靶向治疗的临床获益，HER2/neu检测建议用于晚期和复发性浆液性EC的所有病例。曲妥珠单抗与基于铂和紫杉烷的化疗联合是HER2/neu检测阳性的晚期或复发性浆液性癌症患者的推荐治疗选择。关于靶向治疗的临床试验正在进行中，未来的研究应该集中在选择将从这种治疗中获得最大益处的患者上。
