{"entity":{"id":"paper-galdy-her2-biliary-tract-meta-analysis-cancer-metastasis-rev-2017","kind":"paper","name":"HER2/HER3 pathway in biliary tract malignancies; systematic review and meta-analysis: a potential therapeutic target?","aka":[],"tldr":"Pooling 40 studies, about one in five bile duct and gallbladder cancers outside the liver over-express HER2, against fewer than one in twenty inside the liver, which is why HER2 drugs matter most for gallbladder cancer.","summary":"Systematic review and meta-analysis from Manchester of HER2 and HER3 overexpression (immunohistochemistry) and amplification (in situ hybridisation) in biliary tract cancers; 40 of 440 screened studies qualified. Overall HER2 expression was 26.5 percent (95 percent CI 18.9 to 34.1). In 27 high-quality studies (moderate or strong staining), extrahepatic biliary cancers showed 19.9 percent (12.8 to 27.1) overexpression against 4.8 percent (0 to 14.5) for intrahepatic cholangiocarcinoma (p=0.0049). Amplification was 57.6 percent in patients selected by overexpression and 17.9 percent unselected. HER3 overexpression was 27.9 percent.","asOf":"2026-09-24","links":[{"label":"Cancer Metastasis Rev 2017","url":"https://doi.org/10.1007/s10555-016-9645-x"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27981460/"}],"tags":["gallbladder-evidence"],"related":[],"cancers":["gallbladder","extrahepatic-cholangiocarcinoma","biliary-tract-cancer"],"sections":[],"technologies":[],"targets":["her2"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["her2-positive","ihc","fish"],"trials":[],"people":["angela-lamarca","juan-valle"],"bottlenecks":["b-biomarker-validation"],"keyPapers":[],"journals":["cancer-metastasis-reviews"],"dependsOn":[],"notes":[],"journal":"Cancer Metastasis Reviews","year":2017,"doi":"10.1007/s10555-016-9645-x","pmid":"27981460","authors":"Galdy S, Lamarca A, McNamara MG, et al.","paperType":"meta-analysis","findings":["HER2 overexpression 19.9 percent (95 percent CI 12.8 to 27.1) in extrahepatic biliary cancers vs 4.8 percent (0 to 14.5) in intrahepatic cholangiocarcinoma in high-quality studies.","Amplification 57.6 percent among overexpressors vs 17.9 percent unselected.","HER3 overexpression 27.9 percent."],"whatItMeans":"The prevalence estimate that made HER2 the first gallbladder-relevant target; it argues for testing every advanced gallbladder cancer, since one in five may qualify for zanidatamab or trastuzumab deruxtecan.","caveats":["Scoring criteria varied across studies; the 26.5 percent overall figure includes weak staining.","Gallbladder cancer is pooled with extrahepatic cholangiocarcinoma."],"changedPractice":false},"route":"/key-papers/paper-galdy-her2-biliary-tract-meta-analysis-cancer-metastasis-rev-2017/","neighbours":{"cancer":[{"id":"biliary-tract-cancer","kind":"cancer","name":"Biliary tract cancer (all types)","route":"/cancers/biliary-tract-cancer/"},{"id":"extrahepatic-cholangiocarcinoma","kind":"cancer","name":"Extrahepatic cholangiocarcinoma (perihilar and distal)","route":"/cancers/extrahepatic-cholangiocarcinoma/"},{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"}],"target":[{"id":"her2","kind":"target","name":"HER2","route":"/targets/her2/"}],"term":[{"id":"fish","kind":"term","name":"FISH / ISH (in situ hybridisation)","route":"/terms/fish/"},{"id":"her2-positive","kind":"term","name":"HER2-positive (IHC 3+ or ISH-amplified)","route":"/terms/her2-positive/"},{"id":"ihc","kind":"term","name":"Immunohistochemistry (IHC)","route":"/terms/ihc/"}],"person":[{"id":"angela-lamarca","kind":"person","name":"Angela Lamarca","route":"/people/angela-lamarca/"},{"id":"juan-valle","kind":"person","name":"Juan W. Valle","route":"/people/juan-valle/"}],"bottleneck":[{"id":"b-biomarker-validation","kind":"bottleneck","name":"Biomarkers are not validated or standardised","route":"/bottlenecks/b-biomarker-validation/"}],"journal":[{"id":"cancer-metastasis-reviews","kind":"journal","name":"Cancer metastasis reviews","route":"/journals/cancer-metastasis-reviews/"}],"roadmap":[{"id":"gallbladder-cancer-roadmap","kind":"roadmap","name":"Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials","route":"/roadmaps/gallbladder-cancer-roadmap/"}],"idea":[{"id":"idea-gbc-reflex-her2-testing-advanced-biliary","kind":"idea","name":"Reflex HER2 testing of every advanced gallbladder and extrahepatic biliary cancer","route":"/ideas/idea-gbc-reflex-her2-testing-advanced-biliary/"},{"id":"idea-gbc-report-gallbladder-separately-in-biliary-trials","kind":"idea","name":"Report gallbladder cancer as its own population in every biliary trial","route":"/ideas/idea-gbc-report-gallbladder-separately-in-biliary-trials/"}]}}