The clinicopathological parameters and prognostic significance of HER2 expression in gastric cancer patients: a meta-analysis of literature

Lei, Yuying; Huang, Jinyu; Zhao, Qiongrui; Jiang, Nan; Xu, Hui; Wang, Zhenning; Li, Haiqing; Zhang, Shibo; Sun, Zhe

doi:10.1186/s12957-017-1132-5

Cited by 84 publications

(74 citation statements)

References 57 publications

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“…Overexpression of HER2 has been widely analyzed in gastric cancer series, however, its associations with TRG has not been assessed. The general observation is that HER2+ cases are associated with gender, tumor site, Lauren's classification, tumor node metastasis (TNM) stage, lymph node metastasis, differentiation grade, and distant metastasis . Our data showed that all overexpressed cases were also of intestinal subtype and, although not significant, we found a tendency of association within these parameters.…”

Section: Discussioncontrasting

confidence: 45%

The association among HER2, MET and FOXP3 expression and tumor regression grading in gastric adenocarcinoma

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Pires

Sant'Ana

et al. 2018

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Although the introduction of the perioperative chemotherapy on the management of gastric cancer has improved patients survival, heterogeneity of clinical outcomes has been evidenced in parallel to different histopathological regression pattern of gastric cancer cells. Thus, this study evaluated the tumor regression grading (TRG) in a series of post-treatment gastric tumors and its associations with HER2, MET, and FOXP3 expression. Material of 54 gastric cancer samples was available for TRG evaluation and immunohistochemistry. We found that total and subtotal pathologic response were significantly associated to the intestinal subtype (p = 0.04) and that well-differentiated tumors were significantly correlated with total or partial response (p = 0.019). Although not associated with the TRG, FOXP3 expression in gastric tumors was associated to poorly differentiated tumors (p = 0.03), to the diffuse and mixed subtypes together (p = 0.04) and to the presence of vascular infiltration (p = 0.04), while HER2 overexpression was associated to better differentiated cases (p = 0.04) and to the absence of vascular infiltration (p = 0.02). MET expression, however, showed no association with the analyzed clinicopathological factors. This study highlights the role of tissue differentiation on pathological response to neoadjuvant chemotherapy in gastric cancer and shows no impact between FOXP3, HER2 and MET expression in terms of TRG.

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Section: Discussioncontrasting

confidence: 45%

The association among HER2, MET and FOXP3 expression and tumor regression grading in gastric adenocarcinoma

Filho

Pires

Sant'Ana

et al. 2018

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“…HER-2 positive rates may be associated with sex, tumor site, TNM staging system, distant metastasis, lymph node metastasis, Lauren's classification, and differentiation grade in GC patients. The HER-2 expression rate in Asians may be higher than that in Europeans (17,18).…”

Section: Discussionmentioning

confidence: 99%

Gastric cancer with brain metastasis and the role of human epidermal growth factor 2 status

et al. 2018

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Abstract. Central nervous system (CNS) metastases from cancers of the gastrointestinal tract (GIT) are rare, and occur in 0.16-0.69% of patients with gastric or gastro-esophageal (GE) junction cancer. Overexpression of the human epidermal growth factor 2 (HER-2) is associated with poor prognosis in the absence of HER-2-targeted therapy, and with an increased incidence of CNS metastases in patients with breast cancer. The role of HER-2 overexpression in CNS metastases is not well known in gastric adenocarcinoma. The purpose of the present retrospective study was to assess the incidence of CNS metastases and to evaluate the associations between the CNS and HER-2 status in a series of consecutive patients with gastric or GE junction cancer. Between 2007 and 2013, 300 patients with gastric cancer (GC) or gastroesophageal junction, were admitted to Piacenza General Hospital, Italy. These cases were retrospectively analyzed to evaluate CNS metastases. The metastases were diagnosed with imaging techniques performed on symptomatic patients. Gastric histological samples of patients with CNS metastases were reviewed and tested for HER-2. A total of 7 of the 300 patients (2.33%) with GC were observed to have CNS metastases and 6 (85.71%) had HER-2 positive disease. These patients exhibited a poor prognosis with a median overall survival rate of 4.1 months (range, 2.1-6.6 months). These results suggested there may be CNS recurrence susceptibility in patients with HER-2 positive GC. To the best of our knowledge, this is the first report that associates CNS metastases and HER-2 status in gastric or GE junction cancer.

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“…Overexpression of the HER2-receptor is often associated with cell tumorigenesis and cell proliferation. In a meta-analysis conducted in 17,494 GC patients, HER2 positive rate was 19.1%, even if it seemed slightly lower in Europe than in Asia (respectively 16.9% vs. 19.5%) (11). In this study, it was associated with a poorer prognosis, with a relative risk (RR) of death of 1.47 [95% confidence interval (CI), 1.09-1.98].…”

Section: Current Therapeutic Landscape For Advanced Gastroesophageal mentioning

confidence: 52%

Current therapeutic landscape for advanced gastroesophageal cancers

et al. 2018

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Treatment of advanced gastroesophageal cancers remains challenging for clinicians, patients, and caregivers alike. Despite considerable research, the therapeutic armamentarium is restricted and hardly personalized. In the first-line setting, trastuzumab with a fluoropyrimidine and platinum agent is the standard-of-care in patients with HER2-positive tumor. For the others, a platinum-based doublet (preferably with oxaliplatin) is recommended. Three-drug cytotoxic regimens should be reserved for exceptional cases where patients have good performance status. Triple combinations produce higher toxicity and provide marginal advantage. In the second line setting, the combination of paclitaxel and ramucirumab is preferred over all others. Currently, nothing is approved in the 3 rd or later line. Nivolumab has resulted in an improved benefit in an Asian trial. Early trials of TAS-102, STAT3 inhibitors, anti-claudin 18.2 and other immune checkpoint inhibitors (alone or in combination) are ongoing. However, development of reproducible biomarkers for patient enrichment is critical for future progress.

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The clinicopathological parameters and prognostic significance of HER2 expression in gastric cancer patients: a meta-analysis of literature

Cited by 84 publications

References 57 publications

The association among HER2, MET and FOXP3 expression and tumor regression grading in gastric adenocarcinoma

The association among HER2, MET and FOXP3 expression and tumor regression grading in gastric adenocarcinoma

Gastric cancer with brain metastasis and the role of human epidermal growth factor 2 status

Current therapeutic landscape for advanced gastroesophageal cancers

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