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HER 2 therapy  HER 2/neu diagnostics in breast cancer

HER 2 therapy HER 2/neu diagnostics in breast cancer

measurable circulating HER-2/neu levels. In contrast, reports using the FDA-cleared serum HER-2/neu test reported that all individuals tested, both normal (male and female) and cancer patients, had some level of circulating serum HER-2/ neu. In a 1999 report [26], using the same enzyme-linked immunosorbent assay based on mAb 4D5, baseline serum concentrations of the circulating HER-2/neu were below the detectable concentration in 73 out of 191 patients (38%). The article concluded that no significant correlation could be demonstrated between shed HER-2/neu concentrations and patient response status. However, the conclusions were based on data from a nonvalidated immunoassay with no standardization, and no references demonstrating the specificity of the research assay were presented. However, an explanation for these results can be derived from a report by Wong and Mass [27] presented at the ASCO 2000 annual meeting. In the report they compared the homebrew mAb 4D5 assay with the FDA-cleared test. The poster compared serum samples from the same MBC patients using both the mAb 4D5-based assay and the FDA-cleared assay. The authors concluded that the mAb 4D5 assay was not as sensitive as the FDA-cleared assay, which helps explain the results reported by the above-cited studies as well as other studies using the homebrew mAb 4D5 assay [25,26]. In a similar abstract published in 2004 at the annual ASCO meeting [28], Leyland-Jones and coworkers reported on a study in which they measured HER-2/neu levels in 366 cancer patients, again using the homebrew mAb 4D5 assay. Included was a combination of stage 2 and stage 3 breast cancer patients and patients with non-small-cell lung carcinoma (NSCLC). In the study it was concluded that no obvious relationship existed between baseline HER-2/neu levels and patient response, and in all cases the levels dropped with antiproliferative therapy. Of the 366 patients included in the 2004 poster, 103 patients were from the NSCLC study. Combining breast cancer and NSCLC with stage 2 and 3 cancer studies does not seem appropriate in light of the FDA cleared indication for patients with MBC. Despite the abstract and poster presented in 2000 by Wong and coworkers [27] showing that the 4D5 assay had less analytical sensitivity than the FDA-cleared assay, the authors of the 2004 ASCO poster used the homebrew 4D5 assay. In addition, the FDA assay is cleared for monitoring patients with values above 15 ng/ml. In the 2004 poster by Leyland- Jones and coworkers [28], conclusions were also based on plotting values below 15 ng/ml. To date, these data have not been published in a peer-reviewed journal.
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Expression and prognostic significance of E Cadherin, EGFR,    p53 and HER-2/NEU in Gastric Carcinoma.

Expression and prognostic significance of E Cadherin, EGFR, p53 and HER-2/NEU in Gastric Carcinoma.

The incidence of gastric carcinoma in the year 2011 in RGGGH was 3.26%. Many patients were older than 55 years of age with male preponderance which is similar to several other studies conducted throughout the world. Females showed a younger mean age of incidence compared to males. 29% of cases showed reduced expression of E Cadherin. A significant association was found between reduced expression of E Cadherin and reduced survival. A significant association of EGFR over expression was found with moderately differentiated grade. No significant association was found between EGFR expression and survival. An increased frequency of cases with p53 positivity showed intestinal type of Lauren‘s classification, moderately and poorly differentiated grades and no association between p53 positivity and survival was found. All the cases which showed HER-2/Neu over expression showed T3 level of infiltration, no association with HER- 2/Neu expression and survival was found.
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HER-2/neu Marker Examination using Immunohistochemical Method in Patients Suffering from Gastric Adenocarcinoma

HER-2/neu Marker Examination using Immunohistochemical Method in Patients Suffering from Gastric Adenocarcinoma

The expression of HER-2/neu marker was examined by immunohistochemical staining by Envision method using Hercep Test Kit (Dako, Denmark) according to manufacture's instructions. Briefly, first, 3-4 microns sections of paraffin blocks were prepared and placed on sinalized slides. Then deparaffinisation and rehydration were performed and antigenic recovery was performed in a microwave oven in the presence of citrate buffer. After antigen retrieval, peroxidase was blocked to avoid endogenous peroxidase activity. Then staining with DAB chromogen followed by counterstaining with hematoxylin were performed (15). Also, a sample of breast carcinoma with over- expression of HER-2/neu was used (positive control) during coloration. Then, the slides were scored based on HercepTest Scoring in Dako instruction for gastric biopsies. Zero score was for the cases where the tumor cells or membrane were not stained. +1 score was for weak and diffuse membrane staining of tumor cell clusters (at least 5 cells). +2 score was for weak to moderate, lateral or basolateral complete membrane staining of tumor cell clusters; and+3 score was for strong, lateral or basolateral complete membrane staining of tumor cell clusters (Figures 1-4).
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Role of microvessel density, HER-2/ NEU expression and CD-34 in prognostication and grading of bladder carcinomas.

Role of microvessel density, HER-2/ NEU expression and CD-34 in prognostication and grading of bladder carcinomas.

Of the total 101 transitional cell carcinomas, 50 cases of varying grade and stage were selected in a random manner and subjected to immunohistochemical analysis with a panel of 2 markers – CD 34 and HER-2/neu. The microvessel density was found out by using CD 34. Of the 50 cases, there were 42 males (84%) and 8 females (16%). The ages ranged between 35 and 81 yrs with a mean age of 60.28. There were 3 cases (6%) of small biopsy, 44 cases of TURBT (88%), 2 cases (4%) of simple cystectomy and 1 case (2%) of radical cystectomy. There were 37 cases (74%) below 66 years of age and 13 cases (26%) more than 66 years. The tumour was located in the right lateral wall in 16 cases, left lateral wall in 13 cases, base in 4 cases, dome in 5 cases, posterior wall in 1 case, entire bladder in 6 cases and the tumour is multiple in 5 cases. The tumours ranged in size from 0.5 to 8 cm with a mean size of 4.32.
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HER-2/neu gene analysis on endoscopic biopsy samples and gastric resection materials in gastric carcinomas

HER-2/neu gene analysis on endoscopic biopsy samples and gastric resection materials in gastric carcinomas

Our HER-2/neu positivity rate was determined as 6.4% in our GCa cases by using IHC and FISH methods. Our compatibility rate between HER-2/neu overexpression and gene amplification in resection materials was 90.5%. Our compatibility rate between Bx- IHC and R-IHC was 95,4%. Our rates were consistent with the literature data. Our FN ratio in Bx-IHC was 4.65% and it was low according to the literature. However, Bx-IHC1+ cases were evidently heterogenous for HER-2/neu expression. On the basis of our results, we suggest that HER-2/neu IHC should be performed on WS of resection materials and the assay should be repeated on different tumor areas of IHC negative cases. This strategy will greatly contribute to the detection of more patients who may benefit from trastuzumab treatment.
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Antiangiogenesis immunotherapy induces epitope spreading to Her-2/neu resulting in breast tumor immunoediting

Antiangiogenesis immunotherapy induces epitope spreading to Her-2/neu resulting in breast tumor immunoediting

Tumors were excised fresh and placed into RNAlater solution (Ambion, Austin, TX), stored at 4 ° C for less than two weeks. We extracted mRNA from stored tumors using a Qiagen RNeasy kit (Qiagen, Valencia, CA). We then generated cDNA via PCR using an Applied Biosystems high capacity cDNA reverse transcription kit (Applied Biosystems, Foster City, CA). PCR reactions were performed using PureTaq RTG PCR Beads (GE Healthcare, Piscataway, NJ). Individual PCR samples were further divided to allow sequencing of each individual fragment of Her-2/neu in stretches of 500–800 bp each (EC1 [AA 20–326], EC2 [AA 303–501], EC3 [AA 479–655], IC1 [AA 690–1081], IC2 [AA 1020– 1260]) as was described elsewhere. 11 Primers for these reactions
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Hypoxia-mediated alterations and their role in the HER-2/neu- regulated CREB status and localization

Hypoxia-mediated alterations and their role in the HER-2/neu- regulated CREB status and localization

A role for CREB in the development of tumors has been suggested since it is often overexpressed and more active in many solid and hematopoietic tumors [23-26]. This could be influenced by the modulation of signalling cascades upstream of CREB as well as the induction of the CRE-dependent gene expression downstream of CREB, e.g. matrix metalloproteinases (MMPs), adhesion molecules and different survival factors [20, 27] leading to an increased tumor growth, prevention of cell death, enhanced metastasis formation and angiogenesis [28]. Furthermore, overexpression of CREB in tumors often correlates with disease progression, poor patient survival and chemotherapy resistance [21, 24-26, 29-31]. On the other hand oxygenation in breast cancer is markedly reduced compared to normal tissue [32]. In mammary carcinoma the CREB pathway is often upregulated [33, 34]. An important role of CREB in breast cancer has been further demonstrated by global profiling of signalling networks in breast cancer stem cells [34]. Recently, a correlation between CREB expression/ activation, altered in vitro and in vivo tumor growth properties and HER-2/neu has been described in both in
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Original Article Association between hormone receptors and HER-2/neu is age-related

Original Article Association between hormone receptors and HER-2/neu is age-related

that consider the disease as a single entity [6]. This single estimate does not convey age-relat- ed variation in breast cancer risks. One clini- cally important example is that hormone recep- tors do not predict the HER-2/neu status in all age groups of women [17]. Moreover, different races can also contribute to the variations of breast cancer subtypes. It is reported that the characteristics of breast cancer in Asia is very different from that in non-Asian countries, which is characterized by the early tumor onset, showing a relatively younger median age at diagnosis [18]. In this study, we aimed to inves- tigate the relationship between different age groups and the status of hormone receptors (ER and PR) and HER-2/neu in our local population.
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Nonredundant roles of antibody, cytokines, and perforin in the eradication of established Her 2/neu carcinomas

Nonredundant roles of antibody, cytokines, and perforin in the eradication of established Her 2/neu carcinomas

On the other hand, the enhanced TAA cross-presen- tation that takes place in the presence of antibodies (17), as well as the binding of anti-TAA antibodies to the Fcγ receptors (FcγRs) on APC surfaces (18), may result in the eradication of established tumors in syn- ergy with CD8 T cells (19). In addition, antibodies can sensitize tumors for complement and antibody- dependent cytotoxicity, or they may activate antibody- dependent cellular cytotoxicity (ADCC) through their binding to FcγR on leukocyte membrane (20, 21). Fur- thermore, the results of several vaccination trials have shown that improved survival correlates with the induction of antibodies to TAA (22, 23), and noticeable inhibitions of tumor progression can be obtained through the passive administration of mAb (24, 25). Besides the activation of immunological functions, anti- bodies directed against oncogenic tyrosine kinase recep- tors directly impair the proliferative activity of the target cells. Among these receptors, the protein product of the Her-2/neu oncogene (p185 neu ) has been studied extensive-
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Triple-negative (ER, PgR, HER-2/neu) breast cancer in Indian women

Triple-negative (ER, PgR, HER-2/neu) breast cancer in Indian women

Abstract: The aim of our study was to analyze triple-negative (TN) breast cancer, which is defined as being negative for the estrogen receptor (ER), the progesterone receptor (PgR), and the human epidermal growth factor receptor 2 (HER-2/neu) and which represents a subset of breast cancer with different biologic behavior. We investigated the clinicopathological charac- teristics and prognostic indicators of lymph node-negative TN breast cancer. Medical records were reviewed from patients with node-negative breast cancer who underwent curative surgery at Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India, from May 2007 to October 2010. Clinicopathological variables and clinical outcomes were evaluated. Among 683 patients included, 136 had TN breast cancer and 529 had non-TN breast cancer. TN breast cancer correlated with younger age (,35 years, P = 0.003) and a higher histopathologic and nuclear grade (P , 0.001). It also correlated with a molecular profile associated with biological aggressiveness: negative for Bcl-2 expression (P , 0.001), positive for the epidermal growth factor receptor (P = 0.003), and a high level of p53 (P , 0.001) and Ki-67 expression (P , 0.00). The relapse rates during the follow-up period (median 56.8 months) were 14.7% for TN breast cancer and 6.6% for non-TN breast cancer (P = 0.004). Relapse-free survival (RFS) was sig- nificantly shorter among patients with TN breast cancer compared with those with non-TN breast cancer: 3.5-year RFS rate 85.5% versus 94.2%, respectively; P = 0.001. On multivariate analysis, young age, close resection margin, and triple negativity were independent predictors of shorter RFS. TN breast cancer had a higher relapse rate and more aggressive clinicopathological characteristics than non-TN in node-negative breast cancer. Thus, TN breast cancer should be integrated into risk factor analysis for node-negative breast cancer.
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HER 2/Neu Status in Gastric Carcinomas in a Series of Egyptian Patients and Its Relation to Ki 67 Expression

HER 2/Neu Status in Gastric Carcinomas in a Series of Egyptian Patients and Its Relation to Ki 67 Expression

Objective: HER-2/neu status in gastric carcinomas (GCs) has not been studied before in the Egyp- tian population. Materials and Methods: Seventy-three GCs were evaluated for the expression of HER-2/neu and Ki-67 using immunohistochemistry (IHC). Fluorescence in situ Hybridization (FISH) was done for HER2/neu IHC score 2+ cases. Results: Out of the 73 gastric carcinomas, 23 (31.5%) were score 0, 17 (23.3%) were score 1+, 23 (31.5%) were score 2+, and 10 (13.7%) were score 3+. FISH analysis revealed that the HER-2/neu gene was amplified in 11 out of the 23 cases (47.8%) scored 2+ by IHC. Therefore, the overall HER-2/neu positivity rate was 28.8% and it was signifi- cantly associated with higher T-stage and lymphovascular invasion (LVI). The Ki-67 expression rate ranged between 10% and 100%, with 84.9% of the cases (n = 62) featuring high Ki-67 scores. High Ki-67 score was significantly associated with male sex, tumor grade, and number of positive nodes. HER-2/neu protein expression correlated significantly with Ki-67 score. Twenty tumors showed combined HER-2/neu positivity and high Ki-67 score and were significantly associated with higher T-stage and occurrence of LVI, implying a more aggressive behavior. Conclusions: The rate of HER-2/neu positive GCs in our series simulates universal rates, thereby mandating routine evaluation of HER-2/neu status in all GCs submitted to our laboratory to benefit from trastuzumab therapy. Further studies on a larger number of GCs are required to prove that the concurrent HER-2/neu positivity and high Ki-67 score are markers of worse prognosis.
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Exposure to depleted uranium does not alter the co expression of HER 2/neu and p53 in breast cancer patients

Exposure to depleted uranium does not alter the co expression of HER 2/neu and p53 in breast cancer patients

biological changes may occur that reduce the requirement for continued biomarker signaling. It is also possible that, when gene alterations occur in breast cancer, high prolif- eration rates are found irrespective of the presence of inva- sion and that other molecular alterations are involved in the development of breast cancer [35], Accordingly, the degree of differentiation does not contribute to the increase of the expression of both markers, though it may reflect the possible role of other pathways by which the Table 2 Coexpression of HER-2/neu and p53 in relation to clinicopathological parameters of breast carcinoma
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C myc, not HER 2/neu, can predict recurrence and mortality of patients with node negative breast cancer

C myc, not HER 2/neu, can predict recurrence and mortality of patients with node negative breast cancer

In the present study the oncogenes c-myc and HER-2/ neu were examined with regard to their ability to predict DFS, OS and rate of recurrence, as well as mortality. All patients were randomly selected from one department (Frauenklinik Klinikum Ibbenbueren, Ibbenbueren, Germany). C-myc amplification was identified in 21.5% and HER-2/neu amplification in 30.4%. Berns and coworkers [12–14] reported amplification of c-myc in 20% and of HER-2/neu in 24% using a standard southern blot technique. In a selected high-risk cohort of NNBC patients, Roux-Dosseto et al. [26] applied the same method and found prevalence rates for c-myc and HER-2/ neu amplification of 25% and 31%, respectively. Those oncogenes were assessed in the present study using a double differential PCR technique [17,18,40,43]. Using this method, Brandt et al. [17] found c-myc to be amplified in 19.7% and HER-2/neu in 16.7% of breast cancers, without consideration of nodal status; coamplification of those oncogenes was present in 7%. In the present study, simultaneous amplification of both oncogenes was observed in 12.2%. As in the present investigation, Roux- Dosseto et al. [26] found that c-myc amplification among NNBC patients was significantly associated with earlier recurrence in univariate and multivariate analyses. However, HER-2/neu-amplified NNBC patients did not have the same outcome. Accordingly, c-myc amplification appears to be an independent prognostic marker, which has greater predictive power than does oestrogen recep- tor status and tumour grade. As early as 1992, Berns and coworkers [11,12,14] reported that patients with c-myc- amplified breast cancers had an unfavourable prognosis. The first study to mention possible prognostic importance of HER-2/neu gene amplification was reported in 1987 by Slamon et al. [27]. That study included 187 patients with NNBC and node-positive breast cancer; by univariate and multivariate analyses, it revealed that HER-2/neu amplifi- cation correlated very closely with shorter DFS and OS in a subgroup of 87 node-positive patients. In 1993, in an analysis of 210 patients, Press et al. [7] found that amplifi- cation of HER-2/neu correlated with unfavourable progno- sis with respect to DFS.
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Original Article Evaluation of p16 and HER-2/neu expression in Adenocarcinoma of uterine cervix- A study from tertiary health care center

Original Article Evaluation of p16 and HER-2/neu expression in Adenocarcinoma of uterine cervix- A study from tertiary health care center

Background: Cervical cancer is the most common cancer in women worldwide with current knowledge showing rising trends of adenocarcinoma over Squamous cell carcinoma. They are more aggressive with relatively worse prognosis. Thus, to improve the overall disease free duration, a novel diagnostic and therapeutic immunomarker is required. The present study aims to evaluate the significance of p16 and HER-2/neu expression in patients of adenocarcinoma cervix.

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Association between HER-2/neu over-expression and clinico-pathologic parameters of breast cancer in northern Malaysia

Association between HER-2/neu over-expression and clinico-pathologic parameters of breast cancer in northern Malaysia

Oestrogen and progesterone receptors form an important part of breast cancer management. Oestrogen and progesterone receptor examination is recommended for prediction of response to hormonal treatment. Disease- free and overall survival decrease with less receptors in most cases. However some studies have shown that ER positive patients showed poor prognosis similar to ER negative patients [17, 18]. An interesting phenomenon has been observed with co expression of HER-2/neu with oestrogen receptors. Tumours with positive ER and HER- 2/neu do not response to tamoxifen treatment due to interaction of tyrosine kinase pathway with hormonal pathway [19].
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Concordant morphologic and gene expression data show that a vaccine halts HER 2/neu preneoplastic lesions

Concordant morphologic and gene expression data show that a vaccine halts HER 2/neu preneoplastic lesions

vation of T helper cells producing IFN-γ, the primary switch factor for IgG2a. Following activation by mAb’s to CD3 and CD28, many IFN-γ–producing T cells are present in the spleen of vaccinated mice. These cells contribute to tumor inhibition in several ways other than induction of the Ig isotype switch. Intratumoral release of IFN-γ trig- gers a strong delayed-type hypersensitivity–like reaction with the recruitment of many reactive leukocytes and dendritic cells that is very efficient in tumor debulking and induction of a tumor-specific immune memory (44, 45). Moreover, IFN-γ released by activated T cells changes the genetic program of tumor cells overexpressing the HER-2/neu oncogene and inhibits their proliferation as well as their production of VEGF, while activating their production of the antian- giogenic monokines IP-10 and MIG (9). PCA shows that IFN-γ and IFN-γ–inducible genes are not upmodulated in the wk22pb glands (see additional information, ref. 23), even if upmodulation of the LAT gene (34) indicates the presence of a discrete amounts of T cells. How- ever, at 22 weeks of age (i.e., about 2 months after the boost), the reac- tive cell infiltration is reduced and transcription of IFN-γ and IFN- γ–inducible genes may have been already switched off and returned to basal levels.
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The impact of nottinghem prognostic index (NPI) on the occurrence of relapses in her 2 / NEU positive breast cancer

The impact of nottinghem prognostic index (NPI) on the occurrence of relapses in her 2 / NEU positive breast cancer

The Nottingham Prognostic Index (NPI) unites classic parameters of postoperative histopathological classification of breast - the tumor diameter, lymph-node status, and thedegree of histological differentiation of the tumor which through the Nottingham scoring system incorporate two important elements - mitotic index and the nuclear grade (Lee and Ellis, 2008). Taking into account all previously described parameters that are strongly correlated with the expression of HER-2 / neu, as it was expected, and this parameter reflects the importance of prediction of recurrent disease in HER-2 / neu positive breast cancer as it is described in our and in other studies (Ménard et al., 2001; Miller et al., 2004; Kollias et al., 1999). In our series, 30 out of 33 patients with HER-2 / neu positive breast cancers are in unfavorable prognostic group (90%). This result is similar to the results of Tovey (2009) that reported 68% and Chia (2008) with 73% in a series of patients that have a negative lymph-node status, up to 87% of the patients reported in the series of Sidoni and coworkers (Sidoni et al., 2004). The parameters that are incorporated in the postoperative histopathological classification which determine the stage of the disease, showed that they correlate with the expression of Her-2 / neu thus, the stage of the disease, is an important element in determining the course and outcome of the disease.
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Tumor suppressor genes promote rhabdomyosarcoma progression in p53 heterozygous, HER-2/neu transgenic mice

Tumor suppressor genes promote rhabdomyosarcoma progression in p53 heterozygous, HER-2/neu transgenic mice

A further general question to which the BALB- p53Neu model could contribute is that of the anatomical specificity of carcinogenesis. In most human cancer syndromes only a very specific set of tissues and organs is affected by carcinogenesis, even though the altered genes are ubiquitously expressed. This is also the case of different mouse models of rhabdomyosarcoma that combine p53 inactivation with a second genetic alteration. In our case the activation of HER-2/neu produced rhabdomyosarcomas exclusively in the proximal urethra; Fos knockout lead to periorbital tumors [29]; Ras activation to tumors predominantly on the limbs [30]. The studies reported here revealed significant tissue- specific differences in the expression of p53 and HER-2/ neu that could portend the pattern of tumor development. We found that the preneoplastic proximal urethra of male BALB-p53Neu mice expressed more HER-2/neu and less p53 than that of females, and that such differential expression was not present in skeletal muscles not affected by rhabdomyosarcoma development. Sex- and tissue-specific differences in the expression of the HER- 2/neu transgene (controlled by a mouse mammary tumor virus long terminal repeat) are known to occur and to affect carcinogenesis [31]. To the best of our knowledge, the reduced expression of p53 in specific, tumor-prone tissues of male mice is reported here for the first time, and could synergize with the increased expression of HER-2/neu in the same tissue in determining the onset of rhabdomyosarcoma. Higher level of p53 in urethral tissue of female mice could be due to the activity of estrogens as an upmodulation of p53 protein levels has been reported in cells treated with estradiol [32].
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Unraveling the role of preexisting immunity in prostate cancer patients vaccinated with a HER-2/neu hybrid peptide

Unraveling the role of preexisting immunity in prostate cancer patients vaccinated with a HER-2/neu hybrid peptide

preexisting) and during vaccinations, T cell responses (measured as % of dextramer-specific CD8 + T cells) against other HER-2/neu epitopes or against epitopes from other tumor antigens, representing intramolecular and intermolecular spreading, respectively. Because epi- tope spreading reflects an endogenous immunologic response closely related to the broader spectrum of tumor-specific preexisting immunity, we also analyzed our vaccinated patients for preexisting immunity to the vaccine by AE36-specific IFNγ-based ELISPOT assay and by LR1. We also planned to evaluate whether preexisting immunity to AE36 in combination with epitope spreading was predictive of treatment benefit. With respect to the latter, we analyzed frequencies of CD8 + T cells recognizing CTL specific epitopes restricted by HLA-A2 or HLA-A24, which are the most commonly expressed alleles among our study patients. It has to be mentioned that statistical significance could not be reached in many instances mostly due to the very limited patient numbers compared in each subgroup. However consistent trends can be inter- preted as proof-of-principle data and require further con- sideration. Our data demonstrated that patients with high preexisting immunity to AE36, irrespectively of HLA-A2 or A24 expression, showed statistically significant longer PFS, than patients with low AE36 preexisting immunity, in accordance with our previous observation of improved OS in these patients with high baseline IFN-γ response to the peptide AE36 [10]. Similar results were also obtained in a phase II clinical trial of breast cancer patients vacci- nated with AE37 in the adjuvant setting [48]. To our knowledge, this is the first observation which renders pre- existing immunity to a long peptide vaccine as a predictive biomarker, for the selection of patients most likely to benefit clinically from vaccination.
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Prevalence of HER-2/ neu receptor amplification and its effects over prognosis of the patients with breast cancer

Prevalence of HER-2/ neu receptor amplification and its effects over prognosis of the patients with breast cancer

A total of 120 operated patients with biopsy proven breast carcinoma were included in this study. Information from the patients was collected after taking informed consent from patient, spouse or guardian. The data recorded, included clinical staging, patients taking neoadjuvant therapy or radiotherapy. Frequency of HER2/neu expression and each parameter has been depicted in the following tables and figures. Immunohistochemistry for the assessment of Her2/Neu was done with microscopic examination. The recorded results were then tested and associated with breast cancers prognosis. A total of 120 patients selected for the study, 48(40%) of patients had +ve expression of HER-2/ neu while majority of the patients 72(60%) were found to be negative for HER2/neu (Figure 1).
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