Name: building up a high-throughput screening platform to assess the heterogeneity of her2 gene amplification in breast cancers
Uploaded: 2017-12-05T15:00:00
Description: Watch this Scientific Journal Video about Building Up a High-throughput Screening Platform to Assess the Heterogeneity of HER2 Gene Amplification in Breast Cancers at JoVE.com

This study was approved by the Institutional Review Boards from IRCCS Ca&#39; Granda Foundation, Policlinico Hospital, Milan, Italy.
1. Selection of Patients and Tissue Specimens
<ol>
	<li>Retrieve the archival slides of all cases to be analyzed, including all the available hematoxylin and eosin (H&#38;E) and IHC slides from the original diagnosis and, if present, one H&#38;E of matched non-neoplastic breast tissue (e.g., surgical margin).</li>
	<li>Perform case reviews.</st...

<ol>
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C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recommendations+for+human+epidermal+growth+factor+receptor+2+testing+in+breast+cancer:+American+Society+of+Clinical+Oncology/College+of+American+Pathologists+clinical+practice+guideline+update.">Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update.</a> J Clin Oncol. 31 (31), 3997-4013 (2013).</li><li>Ng, C. K., Pemberton, H. N., Reis-Filho, J. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Breast+cancer+intratumor+genetic+heterogeneity:+causes+and+implications.">Breast cancer intratumor genetic heterogeneity: causes and implications.</a> Expert Rev Anticancer Ther. 12 (8), 1021-1032 (2012).</li><li>Vance, G. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+heterogeneity+in+HER2+testing+in+breast+cancer:+panel+summary+and+guidelines.">Genetic heterogeneity in HER2 testing in breast cancer: panel summary and guidelines.</a> Arch Pathol Lab Med. 133 (4), 611-612 (2009).</li><li>Murthy, S. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+HER2/Neu+status+by+fluorescence+in+situ+hybridization+in+immunohistochemistry-equivocal+cases+of+invasive+ductal+carcinoma+and+aberrant+signal+patterns:+a+study+at+a+tertiary+cancer+center.">Assessment of HER2/Neu status by fluorescence in situ hybridization in immunohistochemistry-equivocal cases of invasive ductal carcinoma and aberrant signal patterns: a study at a tertiary cancer center.</a> Indian J Pathol Microbiol. 54 (3), 532-538 (2011).</li><li>Ohlschlegel, C., Zahel, K., Kradolfer, D., Hell, M., Jochum, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HER2+genetic+heterogeneity+in+breast+carcinoma.">HER2 genetic heterogeneity in breast carcinoma.</a> J Clin Pathol. 64 (12), 1112-1116 (2011).</li><li>Chang, M. C., Malowany, J. I., Mazurkiewicz, J., Wood, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term='Genetic+heterogeneity'+in+HER2/neu+testing+by+fluorescence+in+situ+hybridization:+a+study+of+2,522+cases.">'Genetic heterogeneity' in HER2/neu testing by fluorescence in situ hybridization: a study of 2,522 cases.</a> Mod Pathol. 25 (5), 683-688 (2012).</li><li>Bartlett, A. I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heterogeneous+HER2+gene+amplification:+impact+on+patient+outcome+and+a+clinically+relevant+definition.">Heterogeneous HER2 gene amplification: impact on patient outcome and a clinically relevant definition.</a> Am J Clin Pathol. 136 (2), 266-274 (2011).</li><li>Seol, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intratumoral+heterogeneity+of+HER2+gene+amplification+in+breast+cancer:+its+clinicopathological+significance.">Intratumoral heterogeneity of HER2 gene amplification in breast cancer: its clinicopathological significance.</a> Mod Pathol. 25 (7), 938-948 (2012).</li><li>Hanna, W. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HER2+in+situ+hybridization+in+breast+cancer:+clinical+implications+of+polysomy+17+and+genetic+heterogeneity.">HER2 in situ hybridization in breast cancer: clinical implications of polysomy 17 and genetic heterogeneity.</a> Mod Pathol. 27 (1), 4-18 (2014).</li><li>Sanguedolce, F., Bufo, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HER2+assessment+by+silver+in+situ+hybridization:+where+are+we+now?.">HER2 assessment by silver in situ hybridization: where are we now?.</a> Expert Rev Mol Diagn. 15 (3), 385-398 (2015).</li><li>Fusco, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Contrasting+Role+of+p16Ink4A+Patterns+of+Expression+in+Neuroendocrine+and+Non-Neuroendocrine+Lung+Tumors:+A+Comprehensive+Analysis+with+Clinicopathologic+and+Molecular+Correlations.">The Contrasting Role of p16Ink4A Patterns of Expression in Neuroendocrine and Non-Neuroendocrine Lung Tumors: A Comprehensive Analysis with Clinicopathologic and Molecular Correlations.</a> PLoS One. 10 (12), e0144923 (2015).</li><li>Albanghali, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Construction+of+tissue+microarrays+from+core+needle+biopsies+-+a+systematic+literature+review.">Construction of tissue microarrays from core needle biopsies - a systematic literature review.</a> Histopathology. 68 (3), 323-332 (2016).</li><li>Navani, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Manual+evaluation+of+tissue+microarrays+in+a+high-throughput+research+project:+The+contribution+of+Indian+surgical+pathology+to+the+Human+Protein+Atlas+(HPA)+project.">Manual evaluation of tissue microarrays in a high-throughput research project: The contribution of Indian surgical pathology to the Human Protein Atlas (HPA) project.</a> Proteomics. 16 (8), 1266-1270 (2016).</li><li>Fusco, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HER2+in+gastric+cancer:+a+digital+image+analysis+in+pre-neoplastic,+primary+and+metastatic+lesions.">HER2 in gastric cancer: a digital image analysis in pre-neoplastic, primary and metastatic lesions.</a> Mod Pathol. 26 (6), 816-824 (2013).</li><li>Amin, M. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> AJCC Cancer Staging Manual. , (2017).</li><li>Lakhani, S. R., Ellis, I. O., Schnitt, S. J., Tan, P. H., van de Vijver, M. 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The role of massively parallel sequencing.</a> Histopathology. 68 (2), 262-271 (2016).</li><li>Fusco, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+events+in+the+progression+of+adenoid+cystic+carcinoma+of+the+breast+to+high-grade+triple-negative+breast+cancer.">Genetic events in the progression of adenoid cystic carcinoma of the breast to high-grade triple-negative breast cancer.</a> Mod Pathol. 29 (11), 1292-1305 (2016).</li><li>Fusco, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recurrent+NAB2-STAT6+gene+fusions+and+oestrogen+receptor-&#945;+expression+in+pulmonary+adenofibromas.">Recurrent NAB2-STAT6 gene fusions and oestrogen receptor-&#945; expression in pulmonary adenofibromas.</a> Histopathology. 70 (6), 906-917 (2017).</li><li>Hammond, M. 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Here, we have detailed the laboratory strategies to perform SISH analyses of the HER2 gene and its corresponding centromere in high-yield TMAs of heterogeneously processed breast cancers. This method is cost-effective and can be carried out in most laboratories for the study of HER2 gene amplification heterogeneity in large cohorts of breast cancers retrieved form pathology archives.
Due to the clinical importance of HER2 testing in breast cancer and the challenges generated ...

HER2 is a proto-oncogene that is overexpressed and amplified in 15 - 30% of all invasive breast cancers1,2. HER2 overexpression is inferred by the presence of &#62;10% cells with strong membrane immunohistochemical (IHC) staining (3+), while the gene amplification can be assessed when either the HER2/centromere ratio is &#8805;2 or the gene copy number is &#8805;6, on counting at least 20 cells by in situ hybridization (ISH)3.
Intra-tumor genetic heterogeneity has been widely described in breast cancers, being a potentially adverse contributor to biomarkers evaluation and treatments response4. According to the College of American Pathologists (CAP), HER2 heterogeneity exists if HER2 is amplified in &#62;5% and &#60;50% of infiltrating tumor cells5. Regrettably, the actual incidence of HER2 spatial heterogeneity in breast cancers remains a subject of controversy among pathologists, with some authors maintaining that it is an exceedingly rare event, and others suggesting that up to 40% of cases are HER2-heterogeneous1,5,6,7,8,9,10. Despite the biological mechanisms that underpin this condition are not yet fully clarified, the prognostic and clinical impacts of intra-tumor HER2 heterogeneity are crucial for breast cancer patients11.
Recently, bright-field molecular techniques, such as chromogenic ISH (CISH) and silver ISH (SISH), have emerged as reliable methods to detect HER2 heterogeneity in FFPE tissues, with some advantages compared to fluorescent ISH (FISH)12. Regrettably, the bulk analysis of single cases remains impractical in large-cohort research studies. Several groups have suggested that the combination of histochemistry, IHC, and ISH with TMA technologies could represent a valuable strategy in the study of cancer biology13,14,15,16. With this widely adopted method, tissue samples from different patients can be analyzed concurrently, minimizing the tissue and reagents employed and thereby fostering the uniform analysis of a large series of cases14. However, no protocols are available for the simultaneous high-throughput molecular characterization of multiple tissue samples that underwent different processing in terms of reagents, fixation times, and conservation methods employed, such as archival blocks.
Given the prognostic and clinical implications of HER2 spatial heterogeneity in breast cancers, we developed an integrated molecular platform to assess it in large series of heterogeneously processed cases. Here, we portray the laboratory strategies to generate and analyze the intra-tumor heterogeneity of HER2 amplification in high-yield TMAs of breast cancer by means of SISH. The following protocol has been developed for tumors measuring &#62;5 mm (&#62;pT1b according to the TNM 2017)17. For smaller lesions, we recommend performing the analysis on full-face serial sections. Our procedure allows for the simultaneous IHC and SISH analysis of up to 30 breast cancers, encompassing a mean of 6 distinct areas (range 4 - 8) for each case. Altogether, 180 tissue cores of 1 mm in diameter, with 500 &#181;m between the cores, and 2 mm between the grid and edges will be generated for each TMA block.

<table border="0" cellpadding="0" cellspacing="0" width="1127">
	<tbody>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Surgipath Paraplast</td>
			<td style="width:328px;">Leica Biosystems, Wetzlar, Germany, EU</td>
			<td style="width:120px;">39601006</td>
			<td style="width:383px;">Tissue embedding medium, 56 &#176;C melting point</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Eosin Y&#160; 1% water solution</td>
			<td style="width:328px;">Bio Optica, Milan, Italy, EU</td>
			<td style="width:120px;">510002</td>
			<td style="width:383px;">Eosin yellowish, water-soluble</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Carazzi&#8217;s hematoxylin</td>
			<td style="width:328px;">Bio Optica, Milan, Italy, EU</td>
			<td style="width:120px;">506012</td>
			<td style="width:383px;">Alum hematoxylin ripened using potassium iodate</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Diamond quality</td>
			<td style="width:328px;">Laboindustria, Arzergrande, Italy, EU</td>
			<td style="width:120px;">33533</td>
			<td style="width:383px;">26x76 mm microscope slides</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">Leica CV Mount</td>
			<td style="width:328px;">Leica Biosystems, Wetzlar, Germany, EU</td>
			<td style="width:120px;">14046430011</td>
			<td style="width:383px;">Mounting medium, with no monomers, based on polymers of butylmethacrylate in xylene</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:297px;">FLEX IHC microscope slides</td>
			<td style="width:328px;">Agilent Technologies (Dako),&#160; Santa Clara, CA, USA</td>
			<td style="width:120px;">K8020</td>
			<td style="width:383px;">Coated microscope slides for adhesion of FFPE for use in IHC</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:297px;">BenchMark ULTRA</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">N750-BMKU-FS</td>
			<td style="width:383px;">Slide staining system</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">CONFIRM anti-Estrogen Receptor (ER) (SP1) Rabbit Monoclonal Primary Antibody</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">790-4324</td>
			<td style="width:383px;">Primary antibody, ready-to-use</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">CONFIRM anti-Progesterone Receptor (PR) (1E2) Rabbit Monoclonal Primary Antibody</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">790-2223</td>
			<td style="width:383px;">Primary antibody, ready-to-use</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">CONFIRM anti-Ki-67 (30-9) Rabbit Monoclonal Primary Antibody</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">790-4286</td>
			<td style="width:383px;">Primary antibody, ready-to-use</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">PATHWAY HER2 (4B5) Rabbit Monoclonal Primary Antibody</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">790-4493</td>
			<td style="width:383px;">Primary antibody, ready-to-use</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">ultraView Universal DAB Detection Kit</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">760-500</td>
			<td style="width:383px;">Indirect, biotin-free system for detecting mouse IgG, mouse IgM and rabbit primary antibodies</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">INFORM HER2 Dual ISH DNA Probe Cocktail</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">780-4422</td>
			<td rowspan="3" style="width:383px;">INFORM HER2 Dual ISH assay - Dual color in situ hybridization FDA approved automated assay for determining HER2 gene status in breast cancer patients&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">ultraView Silver ISH DNP Detection Kit</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">800-098</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">ultraView Red ISH DIG Detection Kit</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">800-505</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">ISH Protease 3</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">780-4149</td>
			<td style="width:383px;">Used in the ISH process to remove protein that surrounds the target DNA sequences of interest</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">Hematoxylin</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">760-2021</td>
			<td style="width:383px;">Modified Gill&#39;s hematoxylin counterstain reagent</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">Hematoxylin II Counterstaining</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">790-2208</td>
			<td style="width:383px;">Modified Meyer&#39;s hematoxylin counterstain reagent</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">Bluing reagent</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">760-2037</td>
			<td style="width:383px;">Aqueous solution of buffered lithium carbonate for bluing hematoxylin stained sections on glass slides</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">HybReady</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">780-4409</td>
			<td style="width:383px;">Formamide-based buffer for ISH assays</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">EZ Prep (10x)</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">950-102</td>
			<td style="width:383px;">Concentrate solution for paraffin removal from tissue samples during IHC and ISH reactions, and to dilute 1:10.</td>
		</tr>
		<tr height="80">
			<td height="80" style="height:80px;width:297px;">SSC Buffer (10X)</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">950-110</td>
			<td style="width:383px;">Sodium Chloride Sodium Citrate buffer solution is used for stringency washes and to rinse slides between staining steps and provide a stable aqueous environment for the in situ hybridization reactions. Dilute 1:5.</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:297px;">ULTRA LCS</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">650-210</td>
			<td style="width:383px;">Prediluted (ready-to-use) coverslip solution used as a barrier between the aqueous reagents and the air to prevent evaporation in the IHC and ISH reactions</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">Reaction Buffer (10x)</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">950-300</td>
			<td style="width:383px;">Tris based buffer solution (pH 7.6 &#177; 0.2) to rinse slides between staining steps during IHC and ISH. Dilute 1:10.</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">ULTRA Cell Conditioning (ULTRA CC2)</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">950-223</td>
			<td rowspan="2" style="width:383px;">Pretreatment steps in the processing of tissue samples during IHC and ISH. Ready to use.</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">ULTRA Cell Conditioning (ULTRA CC1)</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">950-224</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">ultraView Silver Wash II</td>
			<td style="width:328px;">Ventana medical system, Tucson, AZ, USA</td>
			<td style="width:120px;">780-003</td>
			<td style="width:383px;">Ready-to-use solution to rinse slides between IHC and ISH staining steps</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Microtome</td>
			<td style="width:328px;">Leica Biosystems, Wetzlar, Germany, EU</td>
			<td style="width:120px;">RM 2255</td>
			<td style="width:383px;">Automated rotary microtome</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Multistainer</td>
			<td style="width:328px;">Leica Biosystems, Wetzlar, Germany, EU</td>
			<td style="width:120px;">ST 5020</td>
			<td style="width:383px;">Workstation for automated staining and coverslipping</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:297px;">Minicore 1</td>
			<td style="width:328px;">Alphelys, Plaisir, France, EU</td>
			<td style="width:120px;">00-MICO-1</td>
			<td style="width:383px;">Semi-automatic arrayer for TMA contruction with TMA Designer 2 embedded software</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:297px;">Aperio ScanScope CS2</td>
			<td style="width:328px;">Leica Biosystems, Wetzlar, Germany, EU</td>
			<td style="width:120px;">K080254</td>
			<td style="width:383px;">Image capture device - digital pathology scanner</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Tissue-Tek III Uni-Cassette</td>
			<td>Sakura Finetek Europe B.V</td>
			<td style="width:120px;">4135</td>
			<td>Cassette</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:297px;">Tissue-Tek Paraform Standard Base Mold</td>
			<td>Sakura Finetek Europe B.V</td>
			<td style="width:120px;">7055</td>
			<td>Stainless-Steel base metal mold</td>
		</tr>
	</tbody>
</table>

building up a high-throughput screening platform to assess the heterogeneity of her2 gene amplification in breast cancers

Targeted therapies against the human epidermal growth factor receptor 2 (HER2) have radically changed the outcome of patients with HER2-positive breast cancers. However, a minority of cases displays a heterogeneous distribution of HER2-positive cells, which generates major clinical challenges. To date, no reliable and standardized protocols for the characterization and quantification of HER2 heterogeneous gene amplification in large cohorts have been proposed. Here, we present a high-throughput methodology to simultaneously assess the HER2 status across different topographic areas of multiple breast cancers. In particular, we illustrate the laboratory procedure to construct enhanced tissue microarrays (TMAs) incorporating a targeted mapping of the tumors. All TMA parameters have been specifically optimized for the silver in situ hybridization (SISH) of formalin-fixed paraffin-embedded (FFPE) breast tissues. Immunohistochemical analysis of the prognostic and predictive biomarkers (i.e., ER, PR, Ki67, and HER2) should be performed using automated procedures. A customized SISH protocol has been implemented to allow a high-quality molecular analysis across multiple tissues that underwent different fixation, processing, and storage procedures. In this study, we provide a proof-of-principle that specific DNA sequences could be localized simultaneously in distinct topographic areas of multiple and heterogeneously processed breast cancers using an efficient and cost-effective method.

Overall, 444 invasive breast cancers were incorporated in 15 TMAs specifically optimized for ISH analyses. Among the 2,664 spots sampled, 2,651 (99.5%) were representative of the previously selected areas and therefore considered amenable for subsequent analyses. Intra-tumor heterogeneity was determined by means of IHC and SIH, with a particular focus on the heterogeneous distributions of HER2-positive clones in the distinct topographic areas of the tumors. Table 3 depict...

Watch this Scientific Journal Video about Building Up a High-throughput Screening Platform to Assess the Heterogeneity of HER2 Gene Amplification in Breast Cancers at JoVE.com

Building Up a High-throughput Screening Platform to Assess the Heterogeneity of HER2 Gene Amplification in Breast Cancers

Heterogeneous distribution of HER2-positive cells can be observed in a subset of breast cancers and generates clinical dilemmas. Here, we introduce a reliable and cost-effective protocol to define, quantify, and compare HER2 intra-tumor genetic heterogeneity in a large series of heterogeneously processed breast cancers.

Targeted therapies against the human epidermal growth factor receptor 2 (HER2) have radically changed the outcome of patients with HER2-positive breast ...

Research

JoVE Journal

Immunology and Infection

An In vitro Model to Study Heterogeneity of Human Macrophage Differentiation and Polarization

An In vitro Model to Study Heterogeneity of Human Macrophage Differentiation and Polarization

Monocyte-derived macrophages represent an important cell type of the innate immune system. Mouse models studying macrophage biology suffer from the ...

A Microscopic Phenotypic Assay for the Quantification of Intracellular Mycobacteria Adapted for High-throughput/High-content Screening

Despite the availability of therapy and vaccine, tuberculosis (TB) remains one of the most deadly and widespread bacterial infections in the world. Since ...

High-throughput Screening for Broad-spectrum Chemical Inhibitors of RNA Viruses

RNA viruses are responsible for major human diseases such as flu, bronchitis, dengue, Hepatitis C or measles. They also represent an emerging threat ...

High-throughput Gene Tagging in Trypanosoma brucei

High-throughput Gene Tagging in Trypanosoma brucei

Improvements in mass spectrometry, sequencing and bioinformatics have generated large datasets of potentially interesting genes. Tagging these proteins ...

A Fluorescence-based Lymphocyte Assay Suitable for High-throughput Screening of Small Molecules

High-throughput screening (HTS) is currently the mainstay for the identification of chemical entities capable of modulating biochemical reactions or ...

A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.

A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.

Fecal-oral transmission of acute gastroenteritis occurs from time to time, especially when people who handled food and water are infected by Salmonella ...

High-throughput Measurement of Plasma Membrane Resealing Efficiency in Mammalian Cells

In their physiological environment, mammalian cells are often subjected to mechanical and biochemical stresses that result in plasma membrane damage. In ...

A High-throughput Assay to Assess and Quantify Neutrophil Extracellular Trap Formation

Neutrophil extracellular traps (NETs) are immunogenic extracellular DNA structures that can be released by neutrophils upon a wide variety of triggers. ...

High-throughput Screening of Chemical Compounds to Elucidate Their Effects on Bacterial Persistence

Bacterial persisters are defined as a small subpopulation of phenotypic variants with the capability of tolerating high concentrations of antibiotics. ...

High-Throughput Transcriptome Analysis for Investigating Host-Pathogen Interactions

Pathogens can cause a wide variety of infectious diseases. The biological processes induced by the host in response to infection determine the severity of ...