Farley John, Fuchiuji Sartoru, Darcy Kathleen M, Tian Chunqiao, Hoskins William J, McGuire William P, Hanjani Parviz, Warshal David, Greer Benjamin E, Belinson Jerome, Birrer Michael J
Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Gynecol Oncol. 2009 Jun;113(3):341-7. doi: 10.1016/j.ygyno.2009.02.009. Epub 2009 Mar 9.
OBJECTIVE(S): The Gynecologic Oncology Group (GOG) examined the association between ERBB2 amplification and clinical covariates, tumor response, disease status post-chemotherapy, progression-free survival (PFS), and overall survival (OS) in epithelial ovarian cancer (EOC).
Women with suboptimally-resected, advanced stage EOC who participated in GOG-111, a multi-center randomized phase III trial of cyclophosphamide+cisplatin versus paclitaxel+cisplatin, and provided a tumor block through the companion protocol GOG-9404 were eligible. ERBB2 amplification was examined using fluorescence in situ hybridization (FISH) with probes for ERBB2 and the centromere of chromosome 17 (CEP17).
ERBB2 amplification, defined as >2 copies of ERBB2/CEP17, was a rare event in EOC with 7% (9/133) of women exhibiting between 2.2 and 33.7 copies of ERBB2/CEP17, and was not associated with patient age, race, GOG performance status, stage, cell type, grade, measurable disease status, volume of ascites, tumor response or disease status post-chemotherapy. Women with >2 verses < or =2 copies of ERBB2/CEP17 did not have a reduced risk of disease progression (hazard ratio [HR]=0.56; 95% confidence interval [CI]=0.27-1.16; p=0.120) or death (HR=0.57; 95% CI=0.26-1.23; p=0.152), and ERBB2 amplification was not an independent prognostic factor for PFS or OS. ERBB2 amplification, defined as >4 copies of ERBB2/nuclei, was observed in 9% (12/133) of women with levels ranging from 4.2 to 49.2 copies of ERBB2/nuclei, and was associated with older age and volume of ascites, but not with the other clinical covariates or outcome.
CONCLUSION(S): ERBB2 amplification is a rare event and has no predictive or prognostic value in suboptimally-resected, advanced stage EOC treated with platinum-based combination chemotherapy.
妇科肿瘤学组(GOG)研究了上皮性卵巢癌(EOC)中ERBB2基因扩增与临床协变量、肿瘤反应、化疗后疾病状态、无进展生存期(PFS)和总生存期(OS)之间的关联。
参加GOG - 111(一项比较环磷酰胺+顺铂与紫杉醇+顺铂的多中心随机III期试验)且通过配套方案GOG - 9404提供肿瘤组织块的次优切除晚期EOC女性符合条件。使用针对ERBB2和17号染色体着丝粒(CEP17)的探针,通过荧光原位杂交(FISH)检测ERBB2基因扩增情况。
ERBB2基因扩增定义为ERBB2/CEP17 > 2拷贝,在EOC中是罕见事件,7%(9/133)的女性ERBB2/CEP17拷贝数在2.2至33.7之间,且与患者年龄、种族、GOG体能状态、分期、细胞类型、分级、可测量疾病状态、腹水量、肿瘤反应或化疗后疾病状态无关。ERBB2/CEP17 > 2拷贝与≤2拷贝的女性疾病进展风险降低(风险比[HR]=0.56;95%置信区间[CI]=0.27 - 1.16;p = 0.120)或死亡风险降低(HR = 0.57;95% CI = 0.26 - 1.23;p = 0.152)无关,ERBB2基因扩增不是PFS或OS的独立预后因素。定义为ERBB2/细胞核> 4拷贝的ERBB2基因扩增在9%(12/133)的女性中观察到,其水平范围为4.2至49.2拷贝的ERBB2/细胞核,且与年龄较大和腹水量相关,但与其他临床协变量或结局无关。
在接受铂类联合化疗的次优切除晚期EOC中,ERBB2基因扩增是罕见事件,无预测或预后价值。