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Volume 12
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10.3390/biomedicines12051088
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Review

Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy

by
Nina Eissler
1,
Renske Altena
2,3,4,
Ali Alhuseinalkhudhur
5,6,
Olga Bragina
7,8,
Joachim Feldwisch
1,
Guido Wuerth
1,
Annika Loftenius
1,
Nikolai Brun
1,
Rimma Axelsson
4,9,
Vladimir Tolmachev
6,
Jens Sörensen
5 and
Fredrik Y. Frejd
1,6,*
1
Affibody AB, 17165 Solna, Sweden
2
Department of Oncology-Pathology, Karolinska Institutet, 17164 Solna, Sweden
3
Medical Unit Breast, Endocrine Tumors and Sarcoma, Theme Cancer, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, 17164 Solna, Sweden
4
Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, 14157 Huddinge, Sweden
5
Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, 75310 Uppsala, Sweden
6
Department of Immunology, Genetics and Pathology, Uppsala University, 75310 Uppsala, Sweden
7
Department of Nuclear Therapy and Diagnostic, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634055 Tomsk, Russia
8
Research Centrum for Oncotheranostics, Research School of Chemistry and Applied Biomedical Sciences, Tomsk Polytechnic University, 634050 Tomsk, Russia
9
Department of Molecular Medicine and Surgery, Karolinska Institutet, 14152 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Biomedicines 2024, 12(5), 1088; https://doi.org/10.3390/biomedicines12051088
Submission received: 5 April 2024 / Revised: 27 April 2024 / Accepted: 8 May 2024 / Published: 14 May 2024
(This article belongs to the Section Drug Discovery, Development and Delivery)
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Abstract

Human epidermal growth factor receptor 2 (HER2) is a major prognostic and predictive marker overexpressed in 15–20% of breast cancers. The diagnostic reference standard for selecting patients for HER2-targeted therapy is based on the analysis of tumor biopsies. Previously patients were defined as HER2-positive or -negative; however, with the approval of novel treatment options, specifically the antibody–drug conjugate trastuzumab deruxtecan, many breast cancer patients with tumors expressing low levels of HER2 have become eligible for HER2-targeted therapy. Such patients will need to be reliably identified by suitable diagnostic methods. Biopsy-based diagnostics are invasive, and repeat biopsies are not always feasible. They cannot visualize the heterogeneity of HER2 expression, leading to a substantial number of misdiagnosed patients. An alternative and highly accurate diagnostic method is molecular imaging with radiotracers. In the case of HER2, various studies demonstrate the clinical utility and feasibility of such approaches. Radiotracers based on Affibody® molecules, small, engineered affinity proteins with a size of ~6.5 kDa, are clinically validated molecules with favorable characteristics for imaging. In this article, we summarize the HER2-targeted therapeutic landscape, describe our experience with imaging diagnostics for HER2, and review the currently available clinical data on HER2-Affibody-based molecular imaging as a novel diagnostic tool in breast cancer and beyond.
Keywords: HER2; breast cancer; diagnostics; molecular imaging; Affibody molecules; clinical trials HER2; breast cancer; diagnostics; molecular imaging; Affibody molecules; clinical trials

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MDPI and ACS Style

Eissler, N.; Altena, R.; Alhuseinalkhudhur, A.; Bragina, O.; Feldwisch, J.; Wuerth, G.; Loftenius, A.; Brun, N.; Axelsson, R.; Tolmachev, V.; et al. Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy. Biomedicines 2024, 12, 1088. https://doi.org/10.3390/biomedicines12051088

AMA Style

Eissler N, Altena R, Alhuseinalkhudhur A, Bragina O, Feldwisch J, Wuerth G, Loftenius A, Brun N, Axelsson R, Tolmachev V, et al. Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy. Biomedicines. 2024; 12(5):1088. https://doi.org/10.3390/biomedicines12051088

Chicago/Turabian Style

Eissler, Nina, Renske Altena, Ali Alhuseinalkhudhur, Olga Bragina, Joachim Feldwisch, Guido Wuerth, Annika Loftenius, Nikolai Brun, Rimma Axelsson, Vladimir Tolmachev, and et al. 2024. "Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy" Biomedicines 12, no. 5: 1088. https://doi.org/10.3390/biomedicines12051088

APA Style

Eissler, N., Altena, R., Alhuseinalkhudhur, A., Bragina, O., Feldwisch, J., Wuerth, G., Loftenius, A., Brun, N., Axelsson, R., Tolmachev, V., Sörensen, J., & Frejd, F. Y. (2024). Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy. Biomedicines, 12(5), 1088. https://doi.org/10.3390/biomedicines12051088

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