title: Her-2/neu expression in prostate adenocarcinoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil.
authors.forename: Ary Serpa
authors.initials: AS
authors.lastname: Neto
authors.forename: Marcos
authors.initials: M
authors.lastname: Tobias-Machado
authors.forename: Marcelo Langer
authors.initials: ML
authors.lastname: Wroclawski
authors.forename: Fernando Luiz Affonso
authors.initials: FL
authors.lastname: Fonseca
authors.forename: Gabriel Kushiyama
authors.initials: GK
authors.lastname: Teixeira
authors.forename: Rodrigo Dal Moro
authors.initials: RD
authors.lastname: Amarante
authors.forename: Eric Roger
authors.initials: ER
authors.lastname: Wroclawski
authors.forename: Auro
authors.initials: A
authors.lastname: Del Giglio
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000097:blood / Q000378:metabolism*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis* / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases