title: Imaging Diagnostic and Therapeutic Targets: Human Epidermal Growth Factor Receptor 2.
abstract: Since the approval of trastuzumab, a humanized monoclonal antibody against the extracellular domain of human epidermal growth factor receptor 2 (HER2), 3 other HER2-targeting agents have gained regulatory approval: lapatinib, pertuzumab, and trastuzumab-emtansine. These agents have revolutionized the management of HER2-positive breast cancer, highlighting the concept that targeted therapies are successful when patients exhibit tumor-selective expression of a molecular target-in this case, HER2. However, response prediction and innate or acquired resistance remain serious concerns. Predictive biomarkers of a response-which could help in the selection of patients who might benefit from a selected targeted therapy-are currently lacking. Molecular imaging with anti-HER2 probes allows the noninvasive, whole-body assessment of HER2 tumor burden and has the potential to improve patient selection, optimize the dose and schedule, and rationalize assessment of the response to anti-HER2 therapies. Furthermore, unlike biopsy-based HER2 assessment, this approach can reveal inter- or intratumoral heterogeneity as well as variations in HER2 expression over time. This review summarizes the available literature and the current status of molecular imaging as a tool for the assessment of HER2 (target) expression or the prediction of an early treatment response in early and advanced HER2-positive breast cancer.
authors.affiliation: Department of Nuclear Medicine, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium geraldine.gebhart@bordet.be.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Gebhart
authors.affiliation: Department of Nuclear Medicine, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Flamen
authors.affiliation: Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and.
authors.forename: Elisabeth G E
authors.initials: EG
authors.lastname: De Vries
authors.affiliation: Breast Medicine Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Komal
authors.initials: K
authors.lastname: Jhaveri
authors.affiliation: Department of Nuclear Medicine, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors.forename: Zena
authors.initials: Z
authors.lastname: Wimana
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics*; D005260:Female; D006801:Humans; D057054:Molecular Imaging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis / Q000187:drug effects* / Q000235:genetics*
chemical_list: D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: HER2 imaging; PET/CT; SPECT/CT; breast oncology; human epidermal growth factor receptor; molecular imaging