title: Epidermal growth factor receptor amplification does not have prognostic significance in patients with glioblastoma multiforme.
abstract: OBJECTIVE
  There have been conflicting reports in the literature regarding the prognostic significance of epidermal growth factor receptor (EGFR) amplification in patients with glioblastoma multiforme (GBM). The purpose of this study is to determine the prognostic significance of EGFR amplification in patients with GBM treated at the Cleveland Clinic Foundation.
  
  
  METHODS
  A retrospective review of GBM patients treated with surgery at the Cleveland Clinic Foundation was performed. Amplification of EGFR was evaluated with fluorescence in situ hybridization in a total of 107 patients diagnosed between December 1995 and May 2003. In addition to EGFR status, various prognostic factors were evaluated to determine the factors that influenced survival and radiographic response rate. The median follow-up was 9 months.
  
  
  RESULTS
  The overall median survival was 9.8 months, with a 1-year survival of 40%. Of the 107 patients in whom EGFR status was evaluated, 36 (33.6%) were found to have EGFR amplification. On multivariate analysis, median survival was found to be significantly improved for patients with age < 60 (12.6 months vs. 8 months, p = 0.0061), patients with Karnofsky Performance Status > or = 70 (12.1 months vs. 4.4 months, p < 0.0001), patients who had undergone subtotal resection or gross total resection (11.1 months vs. 4.1 months, p = 0.002), and patients who received a radiation dose > or = 60 Gy compared with no radiation (12.7 months vs. 3 months, p < 0.0001). There was no association of EGFR amplification with survival. When stratified by age (< 60 vs. > or = 60), EGFR status still did not reach statistical significance in predicting for survival. For the 81 patients who had radiographic follow-up, the 1-year overall local control was 14%. On univariate analysis, only treatment with radiation (< 60 Gy vs. > or = 60 Gy vs. no radiation, p = 0.03) was found to predict for improved local control. Treatment with radiation did not remain statistically significant on multivariate analysis.
  
  
  CONCLUSIONS
  Epidermal growth factor receptor amplification was not found to be a significant prognostic indicator of overall survival or radiographic local control in patients with GBM treated with surgery at the Cleveland Clinic Foundation. Further studies are needed to fully delineate the significance of this molecular marker in patients with GBM.
authors.affiliation: Department of Radiation Oncology, Brain Tumor Institute, The Cleveland Clinic Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: Aimee L
authors.initials: AL
authors.lastname: Quan
authors.forename: Gene H
authors.initials: GH
authors.lastname: Barnett
authors.forename: Shih-Yuan
authors.initials: SY
authors.lastname: Lee
authors.forename: Michael A
authors.initials: MA
authors.lastname: Vogelbaum
authors.forename: Steven A
authors.initials: SA
authors.lastname: Toms
authors.forename: Susan M
authors.initials: SM
authors.lastname: Staugaitis
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prayson
authors.forename: David M
authors.initials: DM
authors.lastname: Peereboom
authors.forename: Glen H J
authors.initials: GH
authors.lastname: Stevens
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Cohen
authors.forename: John H
authors.initials: JH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000235:genetics* / Q000532:radiotherapy; D066246:ErbB Receptors / Q000235:genetics*; D005784:Gene Amplification; D005909:Glioblastoma / Q000235:genetics* / Q000532:radiotherapy; D006801:Humans; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D011379:Prognosis; D011879:Radiotherapy Dosage; D016019:Survival Analysis
chemical_list: D009363:Neoplasm Proteins; D066246:ErbB Receptors