The Role of Human Epidermal Growth Factor Receptor (HER2/neu) in the Prognosis of Patients with Gastric Cancer

Abstract

Objective: Gastric cancer is one of the oncological challenges, and tendency toward target therapy in this cancer<br />has been increased. Controversy still exists on prognostic value of HER2/neu expression and its relationship with<br />clinicopathological characteristics and survival of gastric cancer patients. In this regard, the present study examined<br />the status of HER2/neu in patients with gastric cancer and its prognostic effects. Methods: Pathological samples of 97<br />gastric cancer patients diagnosed over the last 8 or 9 years (from 2008 to the end of 2017) and treated with 5-fluorouracil,<br />Docetaxel, and Cisplatin (TCF) were studied in this investigation. Patients were assigned to two groups according to<br />their HER2/neu status. First group included patients with positive HER2/neu (Score 3) and second group involved<br />patients with negative HER2/neu (Score 0 and 1). Patients were compared in terms of disease stage, survival rate,<br />and mortality. Results: The mean age of patients was 58 years old. There were 75 men and 22 women in this study.<br />In terms of disease stage, 4, 21, 41, and 31 patients were in stage I, II, III, and IV, respectively. Using IHC method,<br />it was found that 27, 23, 25, and 22 patients had HER2/neu expression with score 0, score +1, score 2+ and score+3,<br />respectively. We discovered that expression of positive HER2/neu was associated with male sex. We also observed<br />that survival and mortality rates following treatment initiation were significantly different between HER2/neu positive<br />and negative gastric cancer patients (P<0.01). Conclusion: Evaluation of HER2/neu status in gastric cancer patients<br />showed that HER2/neu 3+ expression could reduce the patients' survival. Therefore, it is recommended that patients<br />who may benefit from trastuzumab, be treated. A clinical multi-center trial should be also considered for use of this<br />drug in adjuvant cases.