Her-2/neu expression in prostate adenocarcinoma: a systematic review and meta-analysis.
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.
Neto
Ary Serpa
AS
Urologic Oncology Division, Department of Urology, ABC Medicine School, Santo André, São Paulo, Brazil.
Tobias-Machado
Marcos
M
Wroclawski
Marcelo Langer
ML
Fonseca
Fernando Luiz Affonso
FL
Teixeira
Gabriel Kushiyama
GK
Amarante
Rodrigo Dal Moro
RD
Wroclawski
Eric Roger
ER
Del Giglio
Auro
A
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
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases