The human epidermal growth factor receptor (HER) family of receptor tyrosine kinases controls critical pathways involved in
epithelial cell differentiation, growth, division, and motility. Alterations and disruptions in the function of the HER-kinase
axis can lead to malignancy. Many therapeutic agents targeting the HER-kinase axis are approved for clinical use or are in
preclinical/clinical development. The ability to quantitatively image the HER-kinase axis in a noninvasive manner can aid
in lesion detection, patient stratification, new drug development/validation, dose optimization, and treatment monitoring.
This review summarizes the current status in multimodality imaging of the HER-kinase axis using PET, SPECT, optical, and MR
imaging. The targeting ligands used include small-molecule tyrosine kinase inhibitors, peptides, proteins, antibodies, and
engineered antibody fragments. EGFR and HER2 imaging have been well documented in the past, and imaging of HER3, HER4, HER
heterodimers, and HER-kinase mutants deserves significant research effort in the future. Successful development of new HER-kinase-targeted
imaging agents with optimal in vivo stability, targeting efficacy, and desirable pharmacokinetics for clinical translation
will enable maximum benefit in cancer patient management.
Keywords Human epidermal growth factor receptor (HER) tyrosine kinase family - Epidermal growth factor receptor (EGFR) - HER2 - Molecular imaging - Cancer