Loss of HER2 positivity after anti-HER2 chemotherapy in HER2-positive gastric cancer patients: results of the GASTric cancer HER2 reassessment study 3 (GASTHER3)
Background Although discordance in HER2 positivity between primary and metastatic lesions is well established, changes in HER2 positivity after anti-HER2 therapy have not been well evaluated in gastric cancer. We aimed to evaluate whether HER2 expression in gastric cancer is affected by trastuzumab...
Gespeichert in:
| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2019-05, Vol.22 (3), p.527-535 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 535 |
|---|---|
| container_issue | 3 |
| container_start_page | 527 |
| container_title | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association |
| container_volume | 22 |
| creator | Seo, Seyoung Ryu, Min-Hee Park, Young Soo Ahn, Ji Yong Park, Yangsoon Park, Sook Ryun Ryoo, Baek-Yeol Lee, Gin Hyug Jung, Hwoon-Young Kang, Yoon-Koo |
| description | Background
Although discordance in HER2 positivity between primary and metastatic lesions is well established, changes in HER2 positivity after anti-HER2 therapy have not been well evaluated in gastric cancer. We aimed to evaluate whether HER2 expression in gastric cancer is affected by trastuzumab therapy.
Methods
We enrolled 48 HER2-positive advanced gastric cancer patients treated with trastuzumab-containing first-line chemotherapy and had paired biopsies at baseline and after progression.
Results
At baseline, HER2 was positive, with immunohistochemistry (IHC) 2+ and in situ hybridization (ISH)+ in five patients, and with IHC 3+ in 43 patients. Fourteen patients (29.1%) exhibited loss of HER2 positivity on post-progression biopsy: 10 with IHC 0 or 1+, and four with IHC 2+/ISH−. HER2 remained positive on second biopsy in 34 patients: four with IHC 2+/ISH+, and 30 with IHC 3+. Median
H
-scores decreased from 225 to 175 (
p
= 0.047).
HER2
genetic heterogeneity was defined in one of 34 ISH-assessable patients (2.9%) at baseline and seven of 32 (21.9%) at second biopsy. Among 13 patients who received second-line trastuzumab emtansine, three showed HER2-negative conversion; they had no objective response and short progression-free survival (1.2, 1.3, and 3.4 months). Patients with stable HER2 status had a 44% response rate and median progression-free survival of 2.7 (0.4–36.8) months.
Conclusion
A substantial portion of HER2-positive patients showed HER2-negative conversion with increased
HER2
genetic heterogeneity after failure of trastuzumab-containing chemotherapy. Loss of HER2 positivity could be predictive of second-line anti-HER2 treatment, suggesting a need to reexamine HER2 status before initiating second-line anti-HER2 therapy. |
| doi_str_mv | 10.1007/s10120-018-0891-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2129531463</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2129531463</sourcerecordid><originalsourceid>FETCH-LOGICAL-c560t-bfe99dcc754ef94abe9c9a2fbcdfe0549ad316a76a3cf17155768623d746552a3</originalsourceid><addsrcrecordid>eNp9kV1rFTEQhhex2Fr9Ad5IwJt6sTaTbLIb70qpbeFAodbrkJOdbVPOfpjJCufn-E_N-agWQa8SmOd9Z-ApinfAPwHn9SkBB8FLDk3JGwMlvCiOoJK6lJKrl09_YeCweE30yDkoA_pVcSi5bLRR1VHxczESsbFjVxe3gk0jhRR-hLRmrksYmRtSKLcj_4D9mB4wumnNwrDlyz2P7N5RisEz7wafY5NLAYdEn1lEmldpuyGH2eXZ17tn3LY5oiNCoj4nGKW5XTPJTjZkHsuPb4qDzq0I3-7f4-Lbl4u786tycXN5fX62KL3SPJXLDo1pva9VhZ2p3BKNN050S992yFVlXCtBu1o76TuoQalaN1rItq60UsLJ4-Jk1zvF8fuMlGwfyONq5QYcZ7IChFESKi0z-uEv9HGc45Cvs0ICCClraP5LgaibKjvYdMGO8jGbiNjZKYbexbUFbjeW7c6yzZbtxrKFnHm_b56XPba_E09aMyB2AOXRcI_xz-p_t_4CR42wUA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2127843863</pqid></control><display><type>article</type><title>Loss of HER2 positivity after anti-HER2 chemotherapy in HER2-positive gastric cancer patients: results of the GASTric cancer HER2 reassessment study 3 (GASTHER3)</title><source>Springer Nature - Complete Springer Journals</source><source>EZB Electronic Journals Library</source><creator>Seo, Seyoung ; Ryu, Min-Hee ; Park, Young Soo ; Ahn, Ji Yong ; Park, Yangsoon ; Park, Sook Ryun ; Ryoo, Baek-Yeol ; Lee, Gin Hyug ; Jung, Hwoon-Young ; Kang, Yoon-Koo</creator><creatorcontrib>Seo, Seyoung ; Ryu, Min-Hee ; Park, Young Soo ; Ahn, Ji Yong ; Park, Yangsoon ; Park, Sook Ryun ; Ryoo, Baek-Yeol ; Lee, Gin Hyug ; Jung, Hwoon-Young ; Kang, Yoon-Koo</creatorcontrib><description>Background
Although discordance in HER2 positivity between primary and metastatic lesions is well established, changes in HER2 positivity after anti-HER2 therapy have not been well evaluated in gastric cancer. We aimed to evaluate whether HER2 expression in gastric cancer is affected by trastuzumab therapy.
Methods
We enrolled 48 HER2-positive advanced gastric cancer patients treated with trastuzumab-containing first-line chemotherapy and had paired biopsies at baseline and after progression.
Results
At baseline, HER2 was positive, with immunohistochemistry (IHC) 2+ and in situ hybridization (ISH)+ in five patients, and with IHC 3+ in 43 patients. Fourteen patients (29.1%) exhibited loss of HER2 positivity on post-progression biopsy: 10 with IHC 0 or 1+, and four with IHC 2+/ISH−. HER2 remained positive on second biopsy in 34 patients: four with IHC 2+/ISH+, and 30 with IHC 3+. Median
H
-scores decreased from 225 to 175 (
p
= 0.047).
HER2
genetic heterogeneity was defined in one of 34 ISH-assessable patients (2.9%) at baseline and seven of 32 (21.9%) at second biopsy. Among 13 patients who received second-line trastuzumab emtansine, three showed HER2-negative conversion; they had no objective response and short progression-free survival (1.2, 1.3, and 3.4 months). Patients with stable HER2 status had a 44% response rate and median progression-free survival of 2.7 (0.4–36.8) months.
Conclusion
A substantial portion of HER2-positive patients showed HER2-negative conversion with increased
HER2
genetic heterogeneity after failure of trastuzumab-containing chemotherapy. Loss of HER2 positivity could be predictive of second-line anti-HER2 treatment, suggesting a need to reexamine HER2 status before initiating second-line anti-HER2 therapy.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-018-0891-1</identifier><identifier>PMID: 30386954</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Biopsy ; Cancer Research ; Cancer therapies ; Chemotherapy ; Discordance ; ErbB-2 protein ; Gastric cancer ; Gastroenterology ; Hybridization ; Immunohistochemistry ; Immunotherapy ; Medicine ; Medicine & Public Health ; Metastases ; Monoclonal antibodies ; Oncology ; Original Article ; Patients ; Surgical Oncology ; Survival ; Targeted cancer therapy ; Trastuzumab</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2019-05, Vol.22 (3), p.527-535</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018</rights><rights>Gastric Cancer is a copyright of Springer, (2018). All Rights Reserved.</rights><rights>Copyright Springer Nature B.V. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-bfe99dcc754ef94abe9c9a2fbcdfe0549ad316a76a3cf17155768623d746552a3</citedby><cites>FETCH-LOGICAL-c560t-bfe99dcc754ef94abe9c9a2fbcdfe0549ad316a76a3cf17155768623d746552a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-018-0891-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-018-0891-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30386954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seo, Seyoung</creatorcontrib><creatorcontrib>Ryu, Min-Hee</creatorcontrib><creatorcontrib>Park, Young Soo</creatorcontrib><creatorcontrib>Ahn, Ji Yong</creatorcontrib><creatorcontrib>Park, Yangsoon</creatorcontrib><creatorcontrib>Park, Sook Ryun</creatorcontrib><creatorcontrib>Ryoo, Baek-Yeol</creatorcontrib><creatorcontrib>Lee, Gin Hyug</creatorcontrib><creatorcontrib>Jung, Hwoon-Young</creatorcontrib><creatorcontrib>Kang, Yoon-Koo</creatorcontrib><title>Loss of HER2 positivity after anti-HER2 chemotherapy in HER2-positive gastric cancer patients: results of the GASTric cancer HER2 reassessment study 3 (GASTHER3)</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background
Although discordance in HER2 positivity between primary and metastatic lesions is well established, changes in HER2 positivity after anti-HER2 therapy have not been well evaluated in gastric cancer. We aimed to evaluate whether HER2 expression in gastric cancer is affected by trastuzumab therapy.
Methods
We enrolled 48 HER2-positive advanced gastric cancer patients treated with trastuzumab-containing first-line chemotherapy and had paired biopsies at baseline and after progression.
Results
At baseline, HER2 was positive, with immunohistochemistry (IHC) 2+ and in situ hybridization (ISH)+ in five patients, and with IHC 3+ in 43 patients. Fourteen patients (29.1%) exhibited loss of HER2 positivity on post-progression biopsy: 10 with IHC 0 or 1+, and four with IHC 2+/ISH−. HER2 remained positive on second biopsy in 34 patients: four with IHC 2+/ISH+, and 30 with IHC 3+. Median
H
-scores decreased from 225 to 175 (
p
= 0.047).
HER2
genetic heterogeneity was defined in one of 34 ISH-assessable patients (2.9%) at baseline and seven of 32 (21.9%) at second biopsy. Among 13 patients who received second-line trastuzumab emtansine, three showed HER2-negative conversion; they had no objective response and short progression-free survival (1.2, 1.3, and 3.4 months). Patients with stable HER2 status had a 44% response rate and median progression-free survival of 2.7 (0.4–36.8) months.
Conclusion
A substantial portion of HER2-positive patients showed HER2-negative conversion with increased
HER2
genetic heterogeneity after failure of trastuzumab-containing chemotherapy. Loss of HER2 positivity could be predictive of second-line anti-HER2 treatment, suggesting a need to reexamine HER2 status before initiating second-line anti-HER2 therapy.</description><subject>Abdominal Surgery</subject><subject>Biopsy</subject><subject>Cancer Research</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Discordance</subject><subject>ErbB-2 protein</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Hybridization</subject><subject>Immunohistochemistry</subject><subject>Immunotherapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Monoclonal antibodies</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Targeted cancer therapy</subject><subject>Trastuzumab</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kV1rFTEQhhex2Fr9Ad5IwJt6sTaTbLIb70qpbeFAodbrkJOdbVPOfpjJCufn-E_N-agWQa8SmOd9Z-ApinfAPwHn9SkBB8FLDk3JGwMlvCiOoJK6lJKrl09_YeCweE30yDkoA_pVcSi5bLRR1VHxczESsbFjVxe3gk0jhRR-hLRmrksYmRtSKLcj_4D9mB4wumnNwrDlyz2P7N5RisEz7wafY5NLAYdEn1lEmldpuyGH2eXZ17tn3LY5oiNCoj4nGKW5XTPJTjZkHsuPb4qDzq0I3-7f4-Lbl4u786tycXN5fX62KL3SPJXLDo1pva9VhZ2p3BKNN050S992yFVlXCtBu1o76TuoQalaN1rItq60UsLJ4-Jk1zvF8fuMlGwfyONq5QYcZ7IChFESKi0z-uEv9HGc45Cvs0ICCClraP5LgaibKjvYdMGO8jGbiNjZKYbexbUFbjeW7c6yzZbtxrKFnHm_b56XPba_E09aMyB2AOXRcI_xz-p_t_4CR42wUA</recordid><startdate>20190501</startdate><enddate>20190501</enddate><creator>Seo, Seyoung</creator><creator>Ryu, Min-Hee</creator><creator>Park, Young Soo</creator><creator>Ahn, Ji Yong</creator><creator>Park, Yangsoon</creator><creator>Park, Sook Ryun</creator><creator>Ryoo, Baek-Yeol</creator><creator>Lee, Gin Hyug</creator><creator>Jung, Hwoon-Young</creator><creator>Kang, Yoon-Koo</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190501</creationdate><title>Loss of HER2 positivity after anti-HER2 chemotherapy in HER2-positive gastric cancer patients: results of the GASTric cancer HER2 reassessment study 3 (GASTHER3)</title><author>Seo, Seyoung ; Ryu, Min-Hee ; Park, Young Soo ; Ahn, Ji Yong ; Park, Yangsoon ; Park, Sook Ryun ; Ryoo, Baek-Yeol ; Lee, Gin Hyug ; Jung, Hwoon-Young ; Kang, Yoon-Koo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-bfe99dcc754ef94abe9c9a2fbcdfe0549ad316a76a3cf17155768623d746552a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Biopsy</topic><topic>Cancer Research</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Discordance</topic><topic>ErbB-2 protein</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Hybridization</topic><topic>Immunohistochemistry</topic><topic>Immunotherapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Monoclonal antibodies</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Targeted cancer therapy</topic><topic>Trastuzumab</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seo, Seyoung</creatorcontrib><creatorcontrib>Ryu, Min-Hee</creatorcontrib><creatorcontrib>Park, Young Soo</creatorcontrib><creatorcontrib>Ahn, Ji Yong</creatorcontrib><creatorcontrib>Park, Yangsoon</creatorcontrib><creatorcontrib>Park, Sook Ryun</creatorcontrib><creatorcontrib>Ryoo, Baek-Yeol</creatorcontrib><creatorcontrib>Lee, Gin Hyug</creatorcontrib><creatorcontrib>Jung, Hwoon-Young</creatorcontrib><creatorcontrib>Kang, Yoon-Koo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seo, Seyoung</au><au>Ryu, Min-Hee</au><au>Park, Young Soo</au><au>Ahn, Ji Yong</au><au>Park, Yangsoon</au><au>Park, Sook Ryun</au><au>Ryoo, Baek-Yeol</au><au>Lee, Gin Hyug</au><au>Jung, Hwoon-Young</au><au>Kang, Yoon-Koo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Loss of HER2 positivity after anti-HER2 chemotherapy in HER2-positive gastric cancer patients: results of the GASTric cancer HER2 reassessment study 3 (GASTHER3)</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2019-05-01</date><risdate>2019</risdate><volume>22</volume><issue>3</issue><spage>527</spage><epage>535</epage><pages>527-535</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background
Although discordance in HER2 positivity between primary and metastatic lesions is well established, changes in HER2 positivity after anti-HER2 therapy have not been well evaluated in gastric cancer. We aimed to evaluate whether HER2 expression in gastric cancer is affected by trastuzumab therapy.
Methods
We enrolled 48 HER2-positive advanced gastric cancer patients treated with trastuzumab-containing first-line chemotherapy and had paired biopsies at baseline and after progression.
Results
At baseline, HER2 was positive, with immunohistochemistry (IHC) 2+ and in situ hybridization (ISH)+ in five patients, and with IHC 3+ in 43 patients. Fourteen patients (29.1%) exhibited loss of HER2 positivity on post-progression biopsy: 10 with IHC 0 or 1+, and four with IHC 2+/ISH−. HER2 remained positive on second biopsy in 34 patients: four with IHC 2+/ISH+, and 30 with IHC 3+. Median
H
-scores decreased from 225 to 175 (
p
= 0.047).
HER2
genetic heterogeneity was defined in one of 34 ISH-assessable patients (2.9%) at baseline and seven of 32 (21.9%) at second biopsy. Among 13 patients who received second-line trastuzumab emtansine, three showed HER2-negative conversion; they had no objective response and short progression-free survival (1.2, 1.3, and 3.4 months). Patients with stable HER2 status had a 44% response rate and median progression-free survival of 2.7 (0.4–36.8) months.
Conclusion
A substantial portion of HER2-positive patients showed HER2-negative conversion with increased
HER2
genetic heterogeneity after failure of trastuzumab-containing chemotherapy. Loss of HER2 positivity could be predictive of second-line anti-HER2 treatment, suggesting a need to reexamine HER2 status before initiating second-line anti-HER2 therapy.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>30386954</pmid><doi>10.1007/s10120-018-0891-1</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1436-3291 |
| ispartof | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2019-05, Vol.22 (3), p.527-535 |
| issn | 1436-3291 1436-3305 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2129531463 |
| source | Springer Nature - Complete Springer Journals; EZB Electronic Journals Library |
| subjects | Abdominal Surgery Biopsy Cancer Research Cancer therapies Chemotherapy Discordance ErbB-2 protein Gastric cancer Gastroenterology Hybridization Immunohistochemistry Immunotherapy Medicine Medicine & Public Health Metastases Monoclonal antibodies Oncology Original Article Patients Surgical Oncology Survival Targeted cancer therapy Trastuzumab |
| title | Loss of HER2 positivity after anti-HER2 chemotherapy in HER2-positive gastric cancer patients: results of the GASTric cancer HER2 reassessment study 3 (GASTHER3) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T15%3A10%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Loss%20of%20HER2%20positivity%20after%20anti-HER2%20chemotherapy%20in%20HER2-positive%20gastric%20cancer%20patients:%20results%20of%20the%20GASTric%20cancer%20HER2%20reassessment%20study%203%20(GASTHER3)&rft.jtitle=Gastric%20cancer%20:%20official%20journal%20of%20the%20International%20Gastric%20Cancer%20Association%20and%20the%20Japanese%20Gastric%20Cancer%20Association&rft.au=Seo,%20Seyoung&rft.date=2019-05-01&rft.volume=22&rft.issue=3&rft.spage=527&rft.epage=535&rft.pages=527-535&rft.issn=1436-3291&rft.eissn=1436-3305&rft_id=info:doi/10.1007/s10120-018-0891-1&rft_dat=%3Cproquest_cross%3E2129531463%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2127843863&rft_id=info:pmid/30386954&rfr_iscdi=true |