Bulletin du cancer
-
About forty years ago, immuno-targeting of antitumor drugs has been addressed as a way to improve their selectivity towards tumor cells. Despite the wide display of researches to solve inherent problems within this approach, rare were the immuno-conjugates which reached the clinical level. In any case, none of them was introduced in chemotherapy. ⋯ It was also due to the design of the Adept concept. This antibody-directed enzyme prodrug therapy is based upon the use of monoclonal antibody to target an enzyme at the tumor cell surface which ultimately is expected to selectively deliver an antitumor drug from a suitable inactive prodrug. In both cases, clinical trials are in progress and one can expect that, at least, some immuno-conjugates will be soon introduced in cancer chemotherapy.
-
HER2 is a member of tyrosine kinase growth factor receptor family. When activated, it induces an intracellular phosphorylation cascade leading to an increased protein transcription and cellular growth. HER2 is overexpressed or amplified in 20 to 30% of invasive breast cancer where it plays an important role in the natural history of the disease. ⋯ For all those reasons, the tumor HER2 status should probably be "routinely" tested in order to optimize the management of breast cancer patients. Nevertheless, some points remain to be elucidated, including the optimal methods of detection of HER2 (immunohistochemistry, Fish). One of the priorities for future research is to standardize HER2 testing, in order to reduce false-positive results and false-negative results and to better identify patients who are most likely going to benefit from Herceptin.