title: Immunohistochemical expression of human epidermal growth factor receptor (HER)-4 and prognosis in patients with metastatic breast cancer.
abstract: OBJECTIVE
  The clinical value of HER4 - a cell surface receptor that belongs to the human epidermal growth factor receptor family - for predicting survival outcomes in patients with breast cancer remains controversial. Herein, we sought to investigate the prognostic significance of HER4 immunohistochemical expression with respect to progression-free survival (PFS) and overall survival (OS) in Turkish patients with metastatic breast cancer (MBC).
  
  
  METHODS
  MBC patients (N=45; mean age=50.5±12.7 years) were consecutively enrolled between 2000 and 2006 in the Department of Oncology at the Uludag University Medical Center, Bursa, Turkey. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded sections. The predictive value of HER4 expression was investigated by multivariate analysis after allowance for potential confounders.
  
  
  RESULTS
  The mean PFS in the study participants was 11.35 months (range:1-50), whereas the median OS was 22.18 months (range:1-76). The mean PFS in patients with a HER4 immunohistochemical score of 0, 1+, 2+, and 3+ was 11.0 ± 4.8, 11.3 ± 7.7, 11.7 ± 8.1, and 10.4 ± 7.4 months, respectively (p=0.99) . The mean OS in patients with a HER4 score of 0, 1+, 2+, and 3+ was 13.3 ± 6.8, 25.6 ± 10.8, 22.9 ± 10.7, and 13.5 ± 9.9, months, respectively (p=0.44). The results of multivariate Cox regression analysis indicated that the presence of visceral metastases was the only independent prognostic factor for both OS (HR=3.01, 95% CI=1.56-3.99, p <0.01) and PFS (HR=2.91, 95% CI=1.51-3.78, p <0.01).
  
  
  CONCLUSIONS
  HER4 immunohistochemical expression is not an independent predictor of OS and PFS in Turkish MBC patients.
authors: Department of Oncology, Uludag University of Medicine, Bursa, Turkey.
authors: Adem
authors: A
authors: Deligonul
authors: Turkkan
authors: T
authors: Evrensel
authors: Nilufer
authors: N
authors: Avci
authors: Nesrin
authors: N
authors: Ugras
authors: Mehmet
authors: M
authors: Ture
authors: Erdem
authors: E
authors: Cubukcu
authors: Mustafa
authors: M
authors: Hartavi
authors: Omer
authors: O
authors: Fatih Olmez
authors: Ender
authors: E
authors: Kurt
authors: Sahsine
authors: S
authors: Tolunay
authors: Ozkan
authors: O
authors: Kanat
authors: Osman
authors: O
authors: Manavoglu
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D016016:Proportional Hazards Models; D066247:Receptor, ErbB-4 / Q000032:analysis*
chemical_list: D066247:Receptor, ErbB-4