To the EditorFCGR3A and FCGR2A gene polymorphisms have been associated with differential binding affinity to IgG and with prediction of response to monoclonal antibody (mAb) therapy. Gavin and colleagues performed a retrospective evaluation of these polymorphisms in a randomized trial of adjuvant chemotherapy with or without trastuzumab (anti-ERBB2/HER2 mAb) in patients with surgically resected node-positive, HER2-positive breast cancer. As expected, they observed that homozygous low-affinity FCGR3A-158 phenylalanine/phenylalanine (F/F) patients received less benefit from trastuzumab than patients with higher-affinity alleles (valine [V]/F or V/V). However, in an exploratory analysis in the nontrastuzumab control arm, patients with FCGR3A-158 V/F or V/V had worse prognosis than patients with F/F. The authors moreover suggested that the differential binding affinity of FCGR proteins to intrinsic antibodies may result in differential benefit from chemotherapy alone.
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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