Prognosis of metastatic gastric and gastroesophageal junction cancer by HER2 status: a European and USA International collaborative analysis

To determine whether human epidermal growth factor receptor 2 (HER2) status is an independent prognostic factor in metastatic gastric and gastroesophageal junction (GEJ) adenocarcinoma. Formalin-fixed paraffin-embedded tumor samples from 381 metastatic gastric/GEJ cancer patients enrolled at Kranken...

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Veröffentlicht in:Annals of oncology 2012-10, Vol.23 (10), p.2656-2662
Hauptverfasser: Janjigian, Y.Y., Werner, D., Pauligk, C., Steinmetz, K., Kelsen, D.P., Jäger, E., Altmannsberger, H.M., Robinson, E., Tafe, L.J., Tang, L.H., Shah, M.A., Al-Batran, S.-E.
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container_end_page 2662
container_issue 10
container_start_page 2656
container_title Annals of oncology
container_volume 23
creator Janjigian, Y.Y.
Werner, D.
Pauligk, C.
Steinmetz, K.
Kelsen, D.P.
Jäger, E.
Altmannsberger, H.M.
Robinson, E.
Tafe, L.J.
Tang, L.H.
Shah, M.A.
Al-Batran, S.-E.
description To determine whether human epidermal growth factor receptor 2 (HER2) status is an independent prognostic factor in metastatic gastric and gastroesophageal junction (GEJ) adenocarcinoma. Formalin-fixed paraffin-embedded tumor samples from 381 metastatic gastric/GEJ cancer patients enrolled at Krankenhaus Nordwest and Memorial Sloan–Kettering Cancer Centers on six first-line trials of chemotherapy without trastuzumab were examined for HER2 by immunohistochemistry (IHC) and in situ hybridization (ISH). IHC 3+ or ISH-positive tumors were considered HER2 positive. Seventy-eight of 381 patients (20%) had HER2-positive disease. In the multivariate logistic model, there were significantly higher rates of HER2 positivity in patients with liver metastasis (liver metastasis 31%; no liver metastasis 11%; P = 0.025) and intestinal histology (intestinal 33%; diffuse/mixed 8%; P = 0.001). No significant differences in HER2 positivity were found between resections and biopsies or primaries and metastases. Patients with HER2-positive gastric cancer had longer median overall survival compared with HER2-negative gastric cancer patients (13.9 versus 11.4 months, P = 0.047), but multivariate analysis indicated that HER2 status was not an independent prognostic factor (hazard ratio 0.79; 0.44–1.14; P = 0.194). Approximately 20% of Western patients with metastatic gastric cancer are HER2 positive. Unlike breast cancer, HER2 positivity is not independently prognostic of patient outcome in metastatic gastric or GEJ.
doi_str_mv 10.1093/annonc/mds104
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Formalin-fixed paraffin-embedded tumor samples from 381 metastatic gastric/GEJ cancer patients enrolled at Krankenhaus Nordwest and Memorial Sloan–Kettering Cancer Centers on six first-line trials of chemotherapy without trastuzumab were examined for HER2 by immunohistochemistry (IHC) and in situ hybridization (ISH). IHC 3+ or ISH-positive tumors were considered HER2 positive. Seventy-eight of 381 patients (20%) had HER2-positive disease. In the multivariate logistic model, there were significantly higher rates of HER2 positivity in patients with liver metastasis (liver metastasis 31%; no liver metastasis 11%; P = 0.025) and intestinal histology (intestinal 33%; diffuse/mixed 8%; P = 0.001). No significant differences in HER2 positivity were found between resections and biopsies or primaries and metastases. Patients with HER2-positive gastric cancer had longer median overall survival compared with HER2-negative gastric cancer patients (13.9 versus 11.4 months, P = 0.047), but multivariate analysis indicated that HER2 status was not an independent prognostic factor (hazard ratio 0.79; 0.44–1.14; P = 0.194). Approximately 20% of Western patients with metastatic gastric cancer are HER2 positive. 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subjects Antineoplastic agents
Biological and medical sciences
Esophageal Neoplasms - metabolism
Esophageal Neoplasms - pathology
esophagogastric cancer
Esophagogastric Junction - pathology
Esophagus
Europe
gastric cancer
Gastroenterology. Liver. Pancreas. Abdomen
gastroesophageal cancer
human epidermal growth factor receptor 2 (HER2)
Humans
Immunohistochemistry
In Situ Hybridization
Medical sciences
Neoplasm Metastasis
Pharmacology. Drug treatments
Prognosis
Stomach Neoplasms - metabolism
Stomach Neoplasms - pathology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumors
United States
title Prognosis of metastatic gastric and gastroesophageal junction cancer by HER2 status: a European and USA International collaborative analysis
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