Prognostic significance of HER2 status evaluation using immunohistochemistry in patients with urothelial carcinoma of the bladder: A retrospective single‑center experience

Abstract

In recent years, antibody-drug conjugate (ADC) therapy targeting human epidermal growth factor receptor 2 (HER2) has been proven to be beneficial in patients with advanced urothelial carcinoma of the bladder (UCB); however, the role of HER2 in UCB remains obscure. Thus, the present retrospective single-center study was performed to evaluate the expression of HER2 in UCB and its prognostic significance. The HER2 status of 108 patients with UCB who underwent radical cystectomy was assessed using immunohistochemistry, and its association with the recurrence and survival rates of patients was analyzed. HER2 overexpression was observed in 57.4% of the patients; this was significantly associated with higher tumor grades (P=0.006) and stages (P<0.001). Kaplan-Meier analysis suggested that patients with HER2 overexpression had a shorter 5-year overall survival rate (P=0.005) and recurrence-free survival rate (P=0.003). Multivariate Cox regression analysis indicated that HER2 overexpression was a high-risk independent predictor of UCB recurrence (hazard ratio, 3.61; 95% confidence interval, 1.07-12.18; P=0.039). On the whole, these findings demonstrate that evaluating the HER2 status may improve the prediction of cancer recurrence and may thus guide the selection of patients that will benefit the most from HER2-ADC therapies.

Expression of HER2 in high-grade urothelial carcinoma based on Chinese expert consensus and the clinical effects of disitamab vedotin-tislelizumab combination therapy in the treatment of advanced patients

“…A higher percentage of HER2+ expression is observed in high-grade UC. Bai et al (2022) conducted immunohistochemical staining to evaluate HER2 expression in 108 patients with bladder UC who underwent radical cystectomy. They discovered that 57.4% of patients exhibited HER2 overexpression, which was significantly correlated with elevated tumor grade ( p = 0.006) and staging ( p < 0.001) ( Bai et al, 2022 ).…”

“… Bai et al (2022) conducted immunohistochemical staining to evaluate HER2 expression in 108 patients with bladder UC who underwent radical cystectomy. They discovered that 57.4% of patients exhibited HER2 overexpression, which was significantly correlated with elevated tumor grade ( p = 0.006) and staging ( p < 0.001) ( Bai et al, 2022 ). A meta-analysis by Zhao et al (2015) also revealed a positive association between HER2 expression and high tumor grade.…”

Advances in HER2-Targeted Treatment for Advanced/Metastatic Urothelial Carcinoma

“…Several investigators studied the HER2 positivity rate in UC and found that the rate varied, approximately ranging from 7% to 80%[ 17-26 ]. Studies examining the HER2 status and its prognostic value are summarized in Table 1 .…”

“…The HER2 status is significantly related to tumor stage and disease grade. In UC, HER2 expression is significantly increased in tumors of higher grades and stages[ 17 , 19 ]. A study discovered that tumors of a luminal molecular subtype had a significantly higher rate of HER2 alterations than those of a basal subtype, suggesting that HER2 activity is also associated with the subtype of tumors[ 18 ].…”