Ito Fuminori, Furukawa Naoto, Nakai Tokiko
*Department of Obstetrics and Gynecology, Nara Medical University; †Department of Obstetrics and Gynecology, Nara Prefecture Western Medical Center; and ‡Department of Pathology, Nara Medical University, Nara, Japan.
Int J Gynecol Cancer. 2016 Feb;26(2):325-30. doi: 10.1097/IGC.0000000000000607.
Paclitaxel plus carboplatin and doxorubicin plus cisplatin are usually selected as adjuvant chemotherapy for endometrial cancer. However, biomarkers that can determine the appropriate chemotherapy regimen are not known. In the present study, we performed a retrospective investigation of the association between TOP2A, HER2 overexpression, and disease-free and overall survival in patients with endometrial cancer receiving taxane and platinum.
Eligible patients had a diagnosis of endometrial cancer based on histology and treated with an adjuvant chemotherapy regimen comprising taxane-platinum after surgery, and the HER2 and TOP2A status of the endometrial cancer regions was determined. Overall survival and disease-free survival between HER2 status and TOP2A status were estimated by the Kaplan-Meier method and compared using the log-rank test.
We identified 56 patients who fulfilled the previously described criteria. Median follow-up was 49 months (range, 18-110 months). HER2-positive tumors were detected in 11 patients (19.6%), and TOP2A-positive tumors were detected in 7 patients (12.5%). Overall survival was not significantly different between patients with HER2-positive tumors and those with HER2-negative tumors, although disease-free survival for patients with HER2-positive tumors was significantly lower than disease-free survival for patients with HER2-negative tumors (P = 0.049). In contrast, patients with TOP2A-positive tumors had significantly lower overall survival than did patients with TOP2A-negative tumors (P = 0.020), and disease-free survival for patients with TOP2A-positive tumors tended to be shorter than for those with TOP2A-negative tumors.
Patients with TOP2A overexpression have a worse prognosis compared with those with TOP2A nonexpression, and TOP2A may be a useful biomarker in patients receiving adjuvant taxane-platinum regimens with moderate- to high-risk endometrial cancer.
紫杉醇联合卡铂以及多柔比星联合顺铂通常被选为子宫内膜癌的辅助化疗方案。然而，目前尚不清楚能够确定合适化疗方案的生物标志物。在本研究中，我们对接受紫杉烷和铂类治疗的子宫内膜癌患者中TOP2A、HER2过表达与无病生存期及总生存期之间的关联进行了回顾性调查。
符合条件的患者根据组织学诊断为子宫内膜癌，术后接受包含紫杉烷-铂类的辅助化疗方案，并确定子宫内膜癌区域的HER2和TOP2A状态。采用Kaplan-Meier法估计HER2状态和TOP2A状态之间的总生存期和无病生存期，并使用对数秩检验进行比较。
我们确定了56例符合上述标准的患者。中位随访时间为49个月（范围18 - 110个月）。11例患者（19.6%）检测到HER2阳性肿瘤，7例患者（12.5%）检测到TOP2A阳性肿瘤。HER2阳性肿瘤患者与HER2阴性肿瘤患者的总生存期无显著差异，尽管HER2阳性肿瘤患者的无病生存期显著低于HER2阴性肿瘤患者（P = 0.049）。相比之下，TOP2A阳性肿瘤患者的总生存期显著低于TOP2A阴性肿瘤患者（P = 0.020），TOP2A阳性肿瘤患者的无病生存期往往短于TOP2A阴性肿瘤患者。
与TOP2A未过表达的患者相比，TOP2A过表达的患者预后较差，并且TOP2A可能是接受中度至高度风险子宫内膜癌辅助紫杉烷-铂类方案治疗患者的一种有用生物标志物。
