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乳癌におけるHER1, HER2発現の治療効果や予後の予測因子としての意義
https://kwmed.repo.nii.ac.jp/records/1326
https://kwmed.repo.nii.ac.jp/records/132646c96b7e-f398-416f-a3db-f23b48c12fea
| 名前 / ファイル | ライセンス | アクション |
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KJ00001563296.pdf (989.8 kB)
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| Item type | [ELS]学術雑誌論文 / Journal Article(1) | |||||||||||
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| 公開日 | 2017-01-23 | |||||||||||
| タイトル | ||||||||||||
| タイトル | 乳癌におけるHER1, HER2発現の治療効果や予後の予測因子としての意義 | |||||||||||
| 言語 | ja | |||||||||||
| タイトル | ||||||||||||
| タイトル | Prognostic and Predictive Values of HER1 and HER2 Overexpression in Breast Cancer | |||||||||||
| 言語 | en | |||||||||||
| 言語 | ||||||||||||
| 言語 | jpn | |||||||||||
| 資源タイプ | ||||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||||||||
| 資源タイプ | journal article | |||||||||||
| 著者 |
山本, 裕
× 山本, 裕
× YAMAMOTO, Yutaka
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| 著者所属(日) | ||||||||||||
| ja | ||||||||||||
| 川崎医科大学外科乳腺甲状腺部門 | ||||||||||||
| 著者所属(英) | ||||||||||||
| en | ||||||||||||
| Division of Breast and Thyroid, Department of Surgery, Kawasaki Medical School | ||||||||||||
| キーワード | ||||||||||||
| 言語 | en | |||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | Breast cancer | |||||||||||
| キーワード | ||||||||||||
| 言語 | en | |||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | HER1 | |||||||||||
| キーワード | ||||||||||||
| 言語 | en | |||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | HER2 | |||||||||||
| キーワード | ||||||||||||
| 言語 | en | |||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | Predictive factor | |||||||||||
| キーワード | ||||||||||||
| 言語 | en | |||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | Prognostic factor | |||||||||||
| 記事種別(日) | ||||||||||||
| 内容記述タイプ | Other | |||||||||||
| 内容記述 | 原著 | |||||||||||
| 言語 | ja | |||||||||||
| 抄録(日) | ||||||||||||
| ja | ||||||||||||
| 増殖因子受容体HER1, HER2の過剰発現は,乳癌の20-40%に認められ,予後不良因子として知られている.また,HER1, HER2を過剰発現する乳癌はホルモン療法に耐性を示し,化学療法(アントラサイクリン[A]やタキサン[T]系薬剤)に良好な反応を示すことが報告されており,治療効果予測因子としても注目されている.さらに最近,HER1, HER2のシグナル伝達を阻害する薬剤が開発され,臨床応用が始まっている.そこで,HER1, HER2の治療効果や予後の予測因子としての有用性を検討した.<対象と方法>1991年～1999年に川崎医科大学乳腺甲状腺外科で根治手術を行った原発乳癌420例のうち,再発後の治療経過が判明している52例を対象とした.原発乳癌標本を用い,HER2, p53, Ki67を免疫組織化学的に検討し,HER1はリガンド結合法にて測定した.治療効果や予後との相関は,単変量及び多変量解析にて分析した.<結果>HER1, HER2, p53の陽性率は,各々30.8%,19.2%,26.9%で,Ki67高標識例は46.2%であった.治療効果や予後との関連をまとめると,1)HER1やHER2陽性症例は,A系薬剤に奏効しやすいが,再発生後生存期間は短く,予後不良であった.2)HER2陽性症例は,T系薬剤に奏効しやすいが,予後とは無関係であった.3)HER1陽性症例は,ホルモン療法に奏効しやすいが,無進行期間や再発後生存期間は短く,予後不良であった.4)Ki67高標識乳癌症例は,ホルモン療法の治療効果とは無関係であったが,再発後生存期間は短く,予後不良であった.<考察>HER1やHER2陽性乳癌は,化学療法やホルモン療法に比較的良く奏効するが,早期に耐性を獲得し,患者を早期に死に至らしめることが示された.今後は,HER1やHER2陽性乳癌に対して,HER1やHER2のシグナル伝達阻害剤の併用が考慮されるべきである. | ||||||||||||
| 抄録(英) | ||||||||||||
| en | ||||||||||||
| Overexpression of the epidermal growth factor receptors, HER1 and HER2, has been detected in 20-40% of primary breast cancers. It has been suggested that patients with breast cancer overexpressing these receptors have a poor prognosis. Their overexpression has been also suggested to be a predictive factor for the response to therapy. HER1-and HER2-overexpressing breast cancers have been shown to be resistant to an antiestrogen, tamoxifen. HER2-overexpressing breast cancer has been reported to be sensitive to anthracycline-containing regimens and taxanes. Recently a selective HER1 tyrosine kinase inhibitor, ZD1839, and a humanized anti-HER2 monoclonal antibody, trastuzumab, have been developed and introduced into clinics. These findings prompted us to investigate the prognostic and predictive values of HER1 and HER2 overexpression in breast cancer. <Patients and Methods> A total of 420 patients underwent radical operaton at the Department of Breast and Thyroid Surgery, Kawasaki Medical School between 1991 and 1999. From among these, 52 patients with recurrent disease in whom response and outcome to therapies were evident were selected as the subjects of this study. Paraffin-embedded primary breast cancer specimens of these patients were immunohistochemically examined for HER2, p53 and Ki67 expression. The HER1 expression was examined by a ligand-binding assay. Correlation between the expression of these biological markers and the survival or response to therapies was investigated using uni- and multivariate analyses. <Results> HER1, HER2 and p53 were overexpressed in 30.8%, 19.2% and 26,9% of breast cancers tested, respectively. A high Ki67-labeling index was observed in 46.2% of them. Systematic analyses on the prognostic and predictive values of HER1 and HER2 overexpression revealed several interesting findings : 1) Patients with breast cancer overexperssing HER1 or HER2 were sensitive to anthracycline-containing regimens. However, their post-relapse survival was significantly shorter than that of the other patients. 2) Patients with HER2-overexpressing breast cancer were significantly more sensitive to taxanes than the others. However, taxancs did not provide a longer post-relapse survival to the patients. 3) Patients with HER1-overexperssing berast cancer tended to be sensitive to endocrine therapy. However, their time-to-progression tended to be shorter, and post-erlapse survival was significantly shoter than that of the others. 4) Patietns with breast cancer showing a high Ki67-labeling index were not resistant to endocrine therapy. Their post-relapse survival was significantly shorter than that of the others. <Conclusion> These findings sugges that patients with breast cancer overexpressing HER1 or HER2 are relatively sensitively to endocrine therapy and chemotherapy, but that such breast cancer rapidly acquires resistance to these therapies, resulting in a shorter survival for the patients. Therefore, involving combined treatment chemotherapy or endocrine therapy and a signal inhibitor of HER1 or HER2 might possibly be superior to chemotherapy or endocrine therapy alone. | ||||||||||||
| 書誌情報 |
ja : 川崎医学会誌 en : Kawasaki medical journal 巻 29, 号 1, p. 47-58, 発行日 2003 |
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| URL | ||||||||||||
| 識別子 | http://igakkai.kms-igakkai.com/wp/wp-content/uploads/2003/KMJ29(1)047-058.2003.pdf | |||||||||||
| 識別子タイプ | URI | |||||||||||
| DOI | ||||||||||||
| 識別子タイプ | DOI | |||||||||||
| 関連識別子 | https://doi.org/10.11482/KMJ29(1)047-058.2003.pdf | |||||||||||
| ISSN | ||||||||||||
| 収録物識別子タイプ | PISSN | |||||||||||
| 収録物識別子 | 0386-5924 | |||||||||||
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| 収録物識別子タイプ | EISSN | |||||||||||
| 収録物識別子 | 2758-089X | |||||||||||
| 雑誌書誌ID | ||||||||||||
| 収録物識別子タイプ | NCID | |||||||||||
| 収録物識別子 | AN00045593 | |||||||||||
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| 収録物識別子タイプ | NCID | |||||||||||
| 収録物識別子 | AN12940574 | |||||||||||
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| 出版タイプ | VoR | |||||||||||
