HER2 becomes a novel survival biomarker for gastric cancer patients: a pooled analysis.

IF 4.3 2区 医学 Q2 ONCOLOGY Therapeutic Advances in Medical Oncology Pub Date : 2024-09-05 DOI:10.1177/17588359241271913
Ji Cheng,Ming Cai,Guobin Wang,Kaixiong Tao
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Abstract

Background Although anti-HER2 therapies have been widely used against gastric carcinoma, the prognostic significance of HER2 overexpression remains unclear. Previous studies failed to provide convincible evidence due to inconsistent HER2 evaluation criteria and heterogeneous clinical characteristics. Objectives To figure out the prognostic significance of HER2 expression in gastric cancer, we rigorously designed and conducted this study. Design Meta-analysis. Data sources and methods Record retrieval was performed by searching PubMed, Web of Science, Cochrane Library, Embase, ASCO, and ESMO meeting libraries from inception to November 2022. Cohort studies investigating overall survival comparison between HER2-positive and HER2-negative gastric cancer patients were included. Both resectable and advanced cases were separately collected while HER2 evaluation standards should be consistent across eligible studies. Newcastle-Ottawa Scale was used for quality assessment. Overall survival was the only endpoint and effect size was presented by hazard ratio (HR) with its 95% confidence interval. The pooled calculation was conducted on Review Manager 5.4. Results Thirty studies were eligible, including 9945 patients. Eligible studies were mostly high quality (n = 31). Regarding resectable cases (n = 22), HER2-positive groups had significantly worse prognosis than HER2-negative counterparts (HR 1.56, 95%CI 1.32-1.85, p < 0.00001). For HER2-positive patients with advanced gastric cancer (n = 10), HER2 overexpression was also an unfavorable survival indicator (HR 1.70, 95%CI 1.23-2.35, p = 0.001). Potential heterogeneous studies had been eliminated while outcomes remained stable by sensitivity analysis. Subgroup analysis suggested HER2-positive patients had a poorer prognosis in both East Asian (resectable: HR 1.56; advanced: HR 1.32) and non-East Asian countries (HR 1.58; HR 3.27). Conclusion As a novel survival biomarker in gastric cancer, HER2 overexpression indicates unfavorable prognosis among both resectable and advanced patients, irrespective of East Asian or non-East Asian populations. Trial registration PROSPERO (CRD42020168051).
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HER2 成为胃癌患者的新型生存生物标志物:一项汇总分析。
背景虽然抗HER2疗法已被广泛应用于胃癌的治疗,但HER2过表达的预后意义仍不明确。为了弄清 HER2 表达在胃癌中的预后意义,我们严格设计并开展了这项研究。数据来源和方法通过搜索 PubMed、Web of Science、Cochrane Library、Embase、ASCO 和 ESMO 会议图书馆,检索从开始到 2022 年 11 月的记录。纳入了调查 HER2 阳性和 HER2 阴性胃癌患者总生存期比较的队列研究。可切除病例和晚期病例均单独收集,同时符合条件的研究应采用一致的 HER2 评估标准。采用纽卡斯尔-渥太华量表进行质量评估。总生存期是唯一的终点,效应大小以危险比(HR)及其95%置信区间表示。结果30项研究符合条件,包括9945名患者。符合条件的研究多为高质量研究(31 项)。就可切除病例(n = 22)而言,HER2 阳性组的预后明显差于 HER2 阴性组(HR 1.56,95%CI 1.32-1.85,p < 0.00001)。对于HER2阳性的晚期胃癌患者(n = 10),HER2过表达也是一个不利的生存指标(HR 1.70,95%CI 1.23-2.35,p = 0.001)。敏感性分析剔除了潜在的异质性研究,结果保持稳定。亚组分析表明,在东亚(可切除:HR 1.56;晚期:HR 1.32)和非东亚国家(HR 1.58;HR 3.27),HER2阳性患者的预后较差。试验注册PROSPERO(CRD42020168051)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.20
自引率
2.00%
发文量
160
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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