HER2 as a Prognostic Marker in Gastric Cancer - A Systematic Analysis of Data from the Literature

Abstract

Through the recent conduct of the ToGA trial, HER2 has shown to be predictive for the treatment with trastuzumab in advanced gastric and gastro-oesophageal cancer. When it comes to the prognostic properties the situation is different. Despite the fact that it is more than 20 years ago since the first studies demonstrating an association between a positive HER2 status and poor prognosis were published the issue is still controversial. In this current systematic review a large number of studies on HER2 and gastric cancer have been reviewed. The studies included in this review should fulfill the following two criteria. First criterion: The number of patients in each study should be ≥ 100, and the HER2 status should have been determined either by immunohistochemistry (IHC) or in situ hybridization (ISH). Second criterion: The selected articles should include an analysis of the association between the HER2 status and survival or relevant clinicopathological characteristics. Forty-two publications with a total of 12,749 patients fulfilled the two criteria and were reviewed in detail. The majority of the publications (71%) showed that a HER2-postive status measured either by IHC or ISH was associated with poor survival and/or clinicopathological characteristics, such as serosal invasion, lymph node metastases, disease stage, or distant metastases. Based on the current analysis a clear trend towards a potential role for HER2 as a negative prognostics factor in gastric cancer was shown, suggesting that HER2 overexpression and/or amplification is a molecular abnormality that might be linked to the development of gastric cancer.

HER-2 incidence in gastric cancer, its association with prognosis and clinicopathological parameters

“…Ulus Cerrahi Derg 2015; 31: 207-13 the intestinal type gastric cancer, 2-7% in diffuse-type gastric cancer, and 5-20% in the mixed type (6,8). In this study, HER-2 positivity was found in 9 patients (12%) with intestinal type gastric cancer (n=67).…”

HER2 Amplification or Overexpression in Upper GI Tract and Breast Cancer with Clinical Diagnosis and Treatment

“…Hoffman et al 36 proved that these FISH criteria for gastric cancer showed a higher concordance (93%) between HER2 amplification and overexpression in gastric cancer. Ruschoff et al 38, 45 (2010, 2012) Recently, Jorgensen and Hersom [56] (2012) reviewed previous studies with more than 100 patients and analysis of association between the HER2 status and survival or relevant clinicopathological characteristics. Forty-two publications with a total of 12,749 patients fulfilled the two criteria and were reviewed in detail.…”

A randomised trial comparing the pharmacokinetics and safety of the biosimilar CT-P6 with reference trastuzumab

“…HER2 over-expression occurs in up to 30% of all breast cancers [3] and at a similar rate in gastric cancers [4]. Over-expression is associated with decreased time to recurrence and poorer prognosis in breast cancer [3,5], and may be linked to worse prognosis and increased recurrence in gastric cancer [4,6].…”