Comparison of HER2 status in primary and paired metastatic sites of gastric carcinoma

Br J Cancer. 2011 Apr 26;104(9):1372-6. doi: 10.1038/bjc.2011.121. Epub 2011 Apr 12.


Background: Trastuzumab has recently shown efficacy in the treatment of HER2-positive advanced gastric adenocarcinoma. Although antibody-based therapies target the metastatic disease, HER2 status is usually evaluated in the primary tumour because metastatic sites are rarely biopsied. The aim of this study was to compare HER2 status in primary and paired metastatic sites of gastric adenocarcinoma.

Methods: The HER2 status was assessed by fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) in 72 secondary lesions of gastric adenocarcinoma and in the corresponding primary tumours.

Results: Concordance of FISH results, evaluable in 68 primary and matched metastatic sites, was 98.5%. Concordance of IHC results, available in 39 of the 72 paired cases, was 94.9%. Only one case showed discordance between primary tumour and metastasis, being negative by both IHC and FISH in the primary and showing HER2 overexpression and amplification in the corresponding pancreatic lymph node metastasis.

Conclusion: The high concordance observed between HER2 results obtained by both IHC and FISH on primary tumours and corresponding metastases suggests that in gastric cancer HER2 status is maintained in most cases unchanged during the metastatic process.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / chemistry*
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology*
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents / therapeutic use
  • Ascitic Fluid / chemistry
  • Biomarkers, Tumor / analysis*
  • Clinical Trials as Topic
  • Esophagogastric Junction
  • Female
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Immunohistochemistry*
  • In Situ Hybridization, Fluorescence*
  • Liver Neoplasms / chemistry
  • Liver Neoplasms / secondary
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / chemistry
  • Peritoneal Neoplasms / secondary
  • Pleural Effusion, Malignant / chemistry
  • Receptor, ErbB-2 / analysis*
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / secondary
  • Stomach Neoplasms / chemistry*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / pathology*
  • Trastuzumab
  • Up-Regulation


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab