Her-2 in gastroesophageal cancer: pathobiology, diagnostic and therapeutic implications
BACKGROUND: The human epidermal growth factor receptor-2 (Her-2) is a membrane-bound tyrosine kinase that is overexpressed in about 15% of gastroesophageal adenocarcinomas. Since recently the first anti-Her-2 targeted therapy (trastuzumab) in combination with standard chemotherapy was approved for the treatment of metastatic and locally advanced gastroesophageal adenocarcinoma. METHODS: Review of the literature. RESULTS: This review gives an overview on the pathobiology of Her-2 and its therapeutical implications in gastroesophageal cancer. Special emphasis is placed on the clinical relevant issues of Her-2 testing and biopsy sampling. CONCLUSIONS: Anti-Her-2 targeted therapies offer novel therapeutic opportunities in advanced stage gastroesophageal adenocarcinomas. With the possible extension of the approval of Her-2 targeted therapies also to the perioperative setting and the possible introduction of alternative Her-2 targeting substances to trastuzumab, Her-2 will stay a highly relevant topic in the treatment of gastroesophageal cancer.