Prognostic significance of HER-2/neu expression in advanced epithelial ovarian cancer: a multivariate analysis.
OBJECTIVE
We tested the hypothesis that there is prognostic significance to the level of expression of the protooncogene HER-2/neu in advanced ovarian cancer, as prior studies have suggested.


METHODS
We determined expression of HER-2/neu by immunohistochemistry, with monoclonal antibody 9G6 and the indirect immunoperoxidase technique, on frozen tumor specimens from 105 patients with stage III or IV epithelial ovarian cancer. All patients were treated at Memorial Sloan-Kettering Cancer Center, and no patient was lost to follow-up. Median follow-up among surviving patients is 34 months. HER-2/neu expression was scored as negative, weak, 1+, 2+, or 3+. The staining pattern of normal ovarian epithelium was scored negative to 1+. Multivariate analysis was performed to evaluate the prognostic significance of HER-2/neu expression.


RESULTS
Twenty-five of the 105 patients (24%) showed strong membrane staining (3+); the other tumor specimens showed weaker membrane staining or no immunoreactivity. There was no correlation of HER-2/neu expression with any of a variety of clinical factors, including stage, grade, cell type, and residual tumor. No significant survival difference was found between patients with levels of staining intensity similar to those of normal ovarian epithelium and those with increased expression (3+). Median survival times were 36 and 27 months, respectively, for the two groups (95% confidence intervals 29 to 45 and 18 to 39 months). Multivariate analysis of possible prognostic factors showed that HER-2/neu overexpression conferred a marginal worsening of survival (p = 0.09) for the subgroup of patients in whom a negative surgical reassessment was not achieved after chemotherapy.


CONCLUSIONS
HER-2/neu expression does not appear to be an important prognostic factor in patients with advanced epithelial ovarian cancer.
Rubin
S C
SC
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Finstad
C L
CL
Wong
G Y
GY
Almadrones
L
L
Plante
M
M
Lloyd
K O
KO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D011247:Pregnancy; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000032:analysis* / Q000235:genetics; D011519:Proto-Oncogenes / Q000235:genetics*; D018719:Erb-b2 Receptor Tyrosine Kinases; D016019:Survival Analysis
D011518:Proto-Oncogene Proteins; D018719:Erb-b2 Receptor Tyrosine Kinases