Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.
Anticancer Res. 2012 Apr;32(4):1547-53.
We aimed to clarify the prognostic significance of HER2 positivity in advanced gastric cancer.
The cohort included patients with initially metastatic or recurrent gastric cancer treated with first-line modified FOLFOX-6. The HER2 status was analyzed according to modified scoring criteria specific for gastric cancer.
HER2 positivity was shown in 10 out of 114 patients (9.0%). The median time-to-progression (TTP) (4.3 months, 95% confidence interval (CI)=3.6-4.9) and the overall survival (OS) (7.5 months, 95% CI=6.1-8.8) of patients with HER2-positive gastric cancer tended to be shorter than the median TTP (5.9 months, 95% CI=4.5-7.2) and OS (10.8 months, 95% CI=9.2-12.3) of those with HER2-negative gastric cancer (TTP, p=0.177; OS, p=0.068). Particularly in the subgroup of patients without diffuse-type histology, HER2-positive gastric cancer had a worse TTP than those with HER2-negative gastric cancer (p=0.024). In multivariate analysis of this subgroup, HER2 positivity and ECOG performance status of 2 were associated with shorter TTP (hazard ratio (HR)=2.926, p=0.014; HR=2.489, p=0.035, respectively).
HER2-positive gastric cancer seems to confer poorer prognosis, particularly in patients without diffuse-type tumor, treated with modified FOLFOX-6.
我们旨在阐明 HER2 阳性在晚期胃癌中的预后意义。
该队列包括接受一线改良 FOLFOX-6 治疗的初诊转移性或复发性胃癌患者。HER2 状态根据特定于胃癌的改良评分标准进行分析。
在 114 名患者中有 10 名（9.0%）HER2 阳性。HER2 阳性胃癌患者的中位无进展生存期（TTP）（4.3 个月，95%置信区间[CI]=3.6-4.9）和总生存期（OS）（7.5 个月，95%CI=6.1-8.8）倾向于短于 HER2 阴性胃癌患者的中位 TTP（5.9 个月，95%CI=4.5-7.2）和 OS（10.8 个月，95%CI=9.2-12.3）（TTP，p=0.177；OS，p=0.068）。特别是在没有弥漫型组织学的患者亚组中，HER2 阳性胃癌的 TTP 短于 HER2 阴性胃癌（p=0.024）。在该亚组的多变量分析中，HER2 阳性和 ECOG 表现状态 2 与较短的 TTP 相关（风险比[HR]=2.926，p=0.014；HR=2.489，p=0.035）。
HER2 阳性胃癌似乎预后较差，特别是在接受改良 FOLFOX-6 治疗的无弥漫型肿瘤患者中。
