ArticleScientific reports2025
Real-time assessment of circulating tumor cells refines the indication for HER2-targeted therapy in metastatic gastric cancer.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Circulating tumour cells for guiding antibody‒drug conjugate therapy: Role of artificial intelligence.Clinical and translational medicine · 2026Review
- Human epidermal growth factor receptor 2 expression loss after neoadjuvant chemotherapy in localized gastroesophageal adenocarcinoma: a retrospective study.Journal of gastrointestinal oncology · 2026Article
- Diagnostic and Therapeutic Challenges Related to HER2 Heterogeneity in Gastric Cancer: Bridging Molecular Pathology and Clinical Decision-Making.International journal of molecular sciences · 2026Review
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Authors and funding
11 authors.
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Abstract
HER2-targeted therapies have improved outcomes in metastatic gastric cancer (mGC), yet assessment of HER2 status in tumor tissues remains limited by heterogeneity and temporal changes. This study aimed to evaluate real-time HER2 expression on circulating tumor cells (CTCs) using the On-chip Sort system. CTCs were enriched from blood samples of 27 mGC patients, identified by cytokeratin staining, and assessed for HER2 expression via fluorescent labeling. The epithelial-mesenchymal transition (EMT) index was calculated based on co-expression of vimentin and cytokeratin. CTCs also underwent whole-genome amplification and targeted sequencing using a cancer gene panel. Patients were stratified into three groups: Group A (n = 13), HER2-positive in tissue; Group B (n = 8), tissue HER2-negative but CTC HER2-positive; and Group C (n = 6), HER2-negative in both tissue and CTCs. All patients received cytotoxic chemotherapy; only Group A received additional HER2-targeted therapy. Group B showed the poorest progression-free survival (PFS: 7.0 months), compared to Group A (15.7 months) and Group C (not reached). CTC HER2 expression correlated with EMT index; Groups A and B also exhibited higher EMT indices and shared EMT-related mutations. These findings suggest that CTC-based HER2 monitoring reflects tumor aggressiveness and may help identify patients who could benefit from HER2-targeted therapy despite negative tissue HER2 status.
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