Clinicopathologic features and treatment outcomes of patients with human epidermal growth factor receptor 2-positive adenocarcinoma of the esophagus and gastroesophageal junction
Diseases of the Esophagus, 06/12/2012
Phillips BE et al. – Given the demonstrated benefit of trastuzumab in Human epidermal growth factor receptor 2 (HER2)–positive gastric cancer and the similar incidence of HER2 overexpression in esophageal/gastroesophageal junction (GEJ) adenocarcinoma, further evaluation of HER2–directed therapy in this disease seems indicated.Methods
- Pathologic specimens from 156 patients with adenocarcinoma of the esophagus/GEJ treated on clinical trials with chemoradiation and surgery were tested for HER2.
- Seventy-six patients also received 2 years of gefitinib.
- Baseline characteristics and treatment outcomes of the HER2-positive and negative patients were compared both in aggregate and separately for each of the two trials.
- Of 156 patients, 135 had sufficient pathologic material available for HER2 assessment.
- HER2 positivity was found in 23%; 28% with GEJ primaries and 15% with esophageal primaries (P= 0.10).
- There was no statistical difference in clinicopathologic features between HER2-positive and negative patients except HER2-negative tumors were more likely to be poorly differentiated (P < 0.001).
- Locoregional recurrence, distant metastatic recurrence, any recurrence, and overall survival were also statistically similar between the HER2-positive and the HER2-negative groups, in both the entire cohort and in the gefitinib-treated subset.
- Except for tumor differentiation, HER2-positive and negative patients with adenocarcinoma of the esophagus and GEJ do not differ in clinicopathologic characteristics and treatment outcomes.