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JNCI Monographs 2001 2001(30):85-87;
© 2001 by Oxford University Press
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Journal of the National Cancer Institute Monographs, No. 30, 85-87, 2001
© 2001 Oxford University Press

Is HER-2/neu a Predictor of Anthracycline Utility? No.

George W. Sledge, Jr.

Correspondence to: George W. Sledge, Jr., M.D., Indiana Cancer Pavilion, RT-473, 575 Barnhill Dr., Indianapolis, IN 46202 (e-mail: gsledge{at}iupui.edu).

HER-2 has a well-established role as a prognostic indicator in breast cancer and as a predictor for response to trastuzumab. Recent studies have also suggested that it may serve as a predictor of response to anthracycline-based therapies. This article argues that the data are insufficient to accept this hypothesis as scientifically established. The argument is developed along several lines: first, that the trials used to support a predictive role for HER-2 have real flaws with regard to this hypothesis; second, that HER-2 is a remarkably inconsistent predictor of anthracycline response when examined in a broader context that includes preoperative and metastatic disease; third, that preclinical data fail to support the hypothesis; and finally, that even if accepted, the hypothesis is difficult to extrapolate to the everyday world of breast cancer.


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