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Browsing by Author "Spears, Patricia A."
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Item FOXA1 and adaptive response determinants to HER2 targeted therapy in TBCRC 036(Springer Nature, 2021-05-12) Angus, Steven P.; Stuhlmiller, Timothy J.; Mehta, Gaurav; Bevill, Samantha M.; Goulet, Daniel R.; Olivares-Quintero, J. Felix; East, Michael P.; Tanioka, Maki; Zawistowski, Jon S.; Singh, Darshan; Sciaky, Noah; Chen, Xin; He, Xiaping; Rashid, Naim U.; Chollet-Hinton, Lynn; Fan, Cheng; Soloway, Matthew G.; Spears, Patricia A.; Jefferys, Stuart; Parker, Joel S.; Gallagher, Kristalyn K.; Forero-Torres, Andres; Krop, Ian E.; Thompson, Alastair M.; Murthy, Rashmi; Gatza, Michael L.; Perou, Charles M.; Earp, H. Shelton; Carey, Lisa A.; Johnson, Gary L.; Pediatrics, School of MedicineInhibition of the HER2/ERBB2 receptor is a keystone to treating HER2-positive malignancies, particularly breast cancer, but a significant fraction of HER2-positive (HER2+) breast cancers recur or fail to respond. Anti-HER2 monoclonal antibodies, like trastuzumab or pertuzumab, and ATP active site inhibitors like lapatinib, commonly lack durability because of adaptive changes in the tumor leading to resistance. HER2+ cell line responses to inhibition with lapatinib were analyzed by RNAseq and ChIPseq to characterize transcriptional and epigenetic changes. Motif analysis of lapatinib-responsive genomic regions implicated the pioneer transcription factor FOXA1 as a mediator of adaptive responses. Lapatinib in combination with FOXA1 depletion led to dysregulation of enhancers, impaired adaptive upregulation of HER3, and decreased proliferation. HER2-directed therapy using clinically relevant drugs (trastuzumab with or without lapatinib or pertuzumab) in a 7-day clinical trial designed to examine early pharmacodynamic response to antibody-based anti-HER2 therapy showed reduced FOXA1 expression was coincident with decreased HER2 and HER3 levels, decreased proliferation gene signatures, and increased immune gene signatures. This highlights the importance of the immune response to anti-HER2 antibodies and suggests that inhibiting FOXA1-mediated adaptive responses in combination with HER2 targeting is a potential therapeutic strategy.Item Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update(ASCO, 2018) Wolff, Antonio C.; Hammond, M. Elizabeth Hale; Allison, Kimberly H.; Harvey, Brittany E.; Mangu, Pamela B.; Bartlett, John M. S.; Bilous, Michael; Ellis, Ian O.; Fitzgibbons, Patrick; Hanna, Wedad; Jenkins, Robert B.; Press, Michael F.; Spears, Patricia A.; Vance, Gail H.; Viale, Giuseppe; McShane, Lisa M.; Dowsett, Mitchell; Medical and Molecular Genetics, School of MedicinePurpose To update key recommendations of the American Society of Clinical Oncology/College of American Pathologists human epidermal growth factor receptor 2 (HER2) testing in breast cancer guideline. Methods Based on the signals approach, an Expert Panel reviewed published literature and research survey results on the observed frequency of less common in situ hybridization (ISH) patterns to update the recommendations. Recommendations Two recommendations addressed via correspondence in 2015 are included. First, immunohistochemistry (IHC) 2+ is defined as invasive breast cancer with weak to moderate complete membrane staining observed in > 10% of tumor cells. Second, if the initial HER2 test result in a core needle biopsy specimen of a primary breast cancer is negative, a new HER2 test may (not “must”) be ordered on the excision specimen based on specific clinical criteria. The HER2 testing algorithm for breast cancer is updated to address the recommended work-up for less common clinical scenarios (approximately 5% of cases) observed when using a dual-probe ISH assay. These scenarios are described as ISH group 2 (HER2/chromosome enumeration probe 17 [CEP17] ratio ≥ 2.0; average HER2 copy number < 4.0 signals per cell), ISH group 3 (HER2/CEP17 ratio < 2.0; average HER2 copy number ≥ 6.0 signals per cell), and ISH group 4 (HER2/CEP17 ratio < 2.0; average HER2 copy number ≥ 4.0 and < 6.0 signals per cell). The diagnostic approach includes more rigorous interpretation criteria for ISH and requires concomitant IHC review for dual-probe ISH groups 2 to 4 to arrive at the most accurate HER2 status designation (positive or negative) based on combined interpretation of the ISH and IHC assays. The Expert Panel recommends that laboratories using single-probe ISH assays include concomitant IHC review as part of the interpretation of all single-probe ISH assay results.