HER-2/neu Expression in Prostate Adenocarcinoma: A Systematic Review and Meta-Analysis

Neto, Ary Serpa; Tobias-Machado, Marcos; Wroclawski, Marcelo Langer; Fonseca, Fernando Luiz Affonso; Teixeira, Gabriel Kushiyama; Amarante, Rodrigo Dal Moro; Wroclawski, Eric Roger; Del Giglio, Auro

doi:10.1016/j.juro.2010.04.077

« Previous Next »The Journal of Urology
Volume 184, Issue 3 , Pages 842-850, September 2010

HER-2/neu Expression in Prostate Adenocarcinoma: A Systematic Review and Meta-Analysis

Ary Serpa Neto
- Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil
Marcos Tobias-Machado
- Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil
- Research Institute, Albert Einstein Jewish Hospital, São Paulo, Brazil
Marcelo Langer Wroclawski
- Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil
- Research Institute, Albert Einstein Jewish Hospital, São Paulo, Brazil
Fernando Luiz Affonso Fonseca
- Oncology Division, Department of Clinical Oncology and Hematology, ABC Medicine School, Santo André, São Paulo, Brazil
Gabriel Kushiyama Teixeira
- Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil
Rodrigo Dal Moro Amarante
- Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil
Eric Roger Wroclawski
- Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil
- Research Institute, Albert Einstein Jewish Hospital, São Paulo, Brazil
Auro Del Giglio
- Oncology Division, Department of Clinical Oncology and Hematology, ABC Medicine School, Santo André, São Paulo, Brazil
- Research Institute, Albert Einstein Jewish Hospital, São Paulo, Brazil
- Correspondence: Department of Hematology and Oncology, ABC Medicine School, Oncology Department, Albert Einstein Jewish Hospital, Rua Mariana Correia, 369-CEP 01400-000-São Paulo, São Paulo, Brazil (telephone and FAX: + 55-11-38195007)

Received 17 November 2009 published online 20 July 2010.

Purpose

HER-2/neu has been linked to the clinical progression of hormone independent prostate cancer. We performed a meta-analysis to investigate the prognostic impact of HER-2/neu over expression in patients with prostate adenocarcinoma, and its correlation with other pathological and clinical variables.

Materials and Methods

We searched the MEDLINE®, Embase®, CancerLit® and ASCO® abstract databases for published studies of HER-2/neu protein expression in primary prostate cancer tissue with a median followup of greater than 2 years and data on survival in patients with and without HER-2/neu over expression. We separately analyzed studies reporting HER-2/neu soluble receptor levels in patients with prostate cancer.

Results

We included 38 articles with a total of 5,976 patients. The overall RR of death in those with HER-2/neu over expression in the primary tumor was 1.63 (95% CI 1.47–1.82, p <0.0001). In the presence of over expression the recurrence RR was 1.87 (95% CI 1.59–2.21, p <0.0001). High HER-2/neu extracellular domain levels also correlated with death (RR 2.01, 95% CI 1.21–3.35, p = 0.007) and recurrence (RR 1.74, 95% CI 1.41–2.15, p <0.0001).

Conclusions

There is a consistent association of HER-2/neu over expression and Gleason less than 7 with a higher RR of death and recurrence in patients with prostate cancer. Further clinical trials should test the hypothesis that HER-2/neu is a marker of a clinically worse outcome in patients with prostate cancer and a potential target for therapy.

Key Words: prostate, adenocarcinoma, genes, erbB-2, neoplasm recurrence, local, mortality

Abbreviations and Acronyms: AR, androgen receptor, ECD, extracellular domain, PSA, prostate specific antigen