PMC7244354_01
Pathologic findings of the primary tumor and the pulmonary lesion specimen after trastuzumab-based therapy. (A) Hematoxylin and eosin staining of the primary tumor revealed bladder adenocarcinoma (magnification x200). (B) Hematoxylin and eosin staining of the pulmonary lesion specimen after trastuzumab-based therapy revealed adenocarcinoma, indicating that it was a metastasis of bladder adenocarcinoma (magnification x200). (C) The primary tumor exhibited strong positive immunohistochemical staining for HER2 (3+) (magnification x200). (D) The pulmonary lesion specimen after trastuzumab-based therapy exhibited positive immunohistochemical staining for HER2 (2+) (magnification x200).
OTT-13-4249-g0001.jpg
PMC7244354_01_OTT-13-4249-g0001.jpg
F0001
The pathological diagnosis was bladder adenocarcinoma (Figure 1A), with immunohistochemistry (IHC) showing CK7 (+), CK20 (+), CDX2 (+), GATA-3 (+-), LI-cad (+), PSA (-), P63 (-), P53 (+), HER2 (3+), and the Ki-67 proliferation index was 80% (Figure 1C). Pathological and histopathological examination revealed metastasis of bladder adenocarcinoma (Figure 1B), with IHC showing HER2 (2+) (Figure 1D).
Chest CT scans before and after trastuzumab-based therapy. (A) Before trastuzumab-based therapy (March 30, 2018), a CT scan showed a lesion in the left lower lung lobe (white arrow). (B) The disease reached partial remission after 2 cycles of trastuzumab-based treatment (May 25, 2018), the mass was reduced significantly (white arrow). (C) Disease progression after trastuzumab-based therapy for six months, enlargement of the mass (white arrow) was observed on October 23, 2018.
OTT-13-4249-g0002.jpg
PMC7244354_01_OTT-13-4249-g0002.jpg
F0002
The CT scan revealed progressed disease (PD), with new lesions identified on March 30, 2018 (Figure 2A). Tumors (RECIST) (version 1.1) and confirmed two months later. Trastuzumab-based therapy was continued for 8 cycles until CT scans revealed enlargement of the lesions (Figure 2C), with a PFS period of 6 months.
Analysis results from the STRING website. (A) Relationship of seven mutant genes before trastuzumab-based therapy. (B) Relationship of five mutant genes after trastuzumab-based therapy.
OTT-13-4249-g0003.jpg
PMC7244354_01_OTT-13-4249-g0003.jpg
F0003
The gene correlation analysis is shown in Figure 3.