title: Plasma HER2 amplification in cell-free DNA during neoadjuvant chemotherapy in breast cancer.
abstract: OBJECTIVE
  Measurement of human epidermal growth factor receptor 2 (HER2) gene amplification in cell-free DNA (cfDNA) is an evolving technique in breast cancer, enabling liquid biopsies and treatment monitoring. The present study investigated the dynamics of plasma HER2 gene copy number and amplification in cfDNA during neoadjuvant chemotherapy.
  
  
  METHODS
  The study included 50 patients from a prospective cohort analyzed during neoadjuvant chemotherapy. Fifty healthy women with no history of cancer served as control group and 15 patients with metastatic breast cancer were used to validate the assay. Total cfDNA and HER2 gene amplification were measured by quantitative real-time polymerase chain reaction.
  
  
  RESULTS
  Plasma HER2 gene copy number (p = 0.794), HER2 gene amplification (p = 0.127) and total cfDNA (p = 0.440) did not differ significantly from the levels in the control group. Eighteen patients (36 %) obtained pathological complete response (pCR). HER2 gene copy number before the operation was significantly higher than the baseline level (p < 0.0001), but there was no difference between patients with and without pCR (p = 0.569). Likewise, there was no difference in plasma HER2 gene amplification between tissue HER2-positive and -negative patients (p = 0.754).
  
  
  CONCLUSIONS
  The results indicate that neither total cfDNA nor HER2 gene copy number is elevated in primary breast cancer patients compared to healthy controls. The level of both parameters increased during neoadjuvant chemotherapy, but without any relation to treatment effect. There was no indication of plasma HER2 gene amplification in the HER2-positive patients in the neoadjuvant setting.
authors.affiliation: The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. troels.bechmann@slb.regionsyddanmark.dk
authors.forename: Troels
authors.initials: T
authors.lastname: Bechmann
authors.forename: Rikke Fredslund
authors.initials: RF
authors.lastname: Andersen
authors.forename: Niels
authors.initials: N
authors.lastname: Pallisgaard
authors.forename: Jonna Skov
authors.initials: JS
authors.lastname: Madsen
authors.forename: Else
authors.initials: E
authors.lastname: Maae
authors.forename: Erik Hugger
authors.initials: EH
authors.lastname: Jakobsen
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Bak Jylling
authors.forename: Karina Dahl
authors.initials: KD
authors.lastname: Steffensen
authors.forename: Anders
authors.initials: A
authors.lastname: Jakobsen
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D004273:DNA, Neoplasm / Q000097:blood / Q000235:genetics*; D005260:Female; D005784:Gene Amplification; D018628:Gene Dosage; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics* / Q000378:metabolism; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D004273:DNA, Neoplasm; D018719:Erb-b2 Receptor Tyrosine Kinases