title: Co-expression of HER family members in patients with Dukes' C and D colon cancer and their impacts on patient prognosis and survival.
abstract: The human epidermal growth factor receptor (EGFR) is an important therapeutic target in patients with metastatic colorectal cancer and anti-EGFR antibodies cetuximab and panitumumab have been approved for the treatment of such patients. Despite these advances, the duration of response in some patients can be limited. Since, EGFR is capable of forming heterodimers with the other members of the HER (Human epidermal receptor) family, it is important to investigate the co-expression and prognostic significance of all members of the HER family in colorectal cancer patients. The expression of the HER family members were determined in tumour specimens from 86 patients with Dukes' C and D (metastatic) colon cancer using immunohistochemistry. Sections were scored by the percentage of positive tumour cells and intensity of staining. Their associations with clinicopathological parameters, and overall survival and disease free survival were evaluated using univariate and multivariate analysis. Overall, 43%, 77%, 52% and 92% of the cases were EGFR, HER-2, HER-3 and HER-4 positive respectively. Interestingly, 35%, 24%, 43%, and 18% of the cases had co-expression of EGFR/HER-2, EGFR/HER-3, EGFR/HER-4 and all four members of the HER family respectively. Of these, only the expression of EGFR and co-expression of EGFR/HER-4 were associated with poorer disease-free survival in both univariate and multivariate analysis. Co-expression of all members of the HER family in colon cancer supports the need for further investigations on their predictive value for response to therapy with anti-EGFR mAbs and whether such sub-population of patients may benefit from therapy with the new generation of pan-HER inhibitors.
authors.affiliation: School of Life Sciences, Kingston University London, Kingston, United Kingdom.
authors.forename: Said Abdullah
authors.initials: SA
authors.lastname: Khelwatty
authors.affiliation: School of Life Sciences, Kingston University London, Kingston, United Kingdom; St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, United Kingdom.
authors.forename: Sharadah
authors.initials: S
authors.lastname: Essapen
authors.affiliation: Department of Histopathology, Royal Surrey County Hospital, Guildford, United Kingdom.
authors.forename: Izhar
authors.initials: I
authors.lastname: Bagwan
authors.affiliation: Department of Histopathology, Royal Surrey County Hospital, Guildford, United Kingdom.
authors.forename: Margaret
authors.initials: M
authors.lastname: Green
authors.affiliation: School of Life Sciences, Kingston University London, Kingston, United Kingdom.
authors.forename: Alan Michael
authors.initials: AM
authors.lastname: Seddon
authors.affiliation: School of Life Sciences, Kingston University London, Kingston, United Kingdom.
authors.forename: Helmout
authors.initials: H
authors.lastname: Modjtahedi
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003110:Colonic Neoplasms / Q000378:metabolism* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000378:metabolism*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D009363:Neoplasm Proteins; D018719:Erb-b2 Receptor Tyrosine Kinases