Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis

Abstract Trastuzumab combined with chemotherapy is standard of care for HER2 positive advanced gastro-esophageal cancers. The reported prevalence of HER2 discordance between primary tumors and corresponding metastases varies, hampering uniform patient selection for HER2 targeted therapy. This meta-a...

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Autores principales:	A. Creemers, E. ter Veer, L. de Waal, P. Lodder, G. K. J. Hooijer, N. C. T. van Grieken, M. F. Bijlsma, S. L. Meijer, M. G. H. van Oijen, H. W. M. van Laarhoven
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/256dfbed0fe34b36901003d0614a20f9
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spelling	oai:doaj.org-article:256dfbed0fe34b36901003d0614a20f92021-12-02T11:40:51ZDiscordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis10.1038/s41598-017-03304-92045-2322https://doaj.org/article/256dfbed0fe34b36901003d0614a20f92017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-03304-9https://doaj.org/toc/2045-2322Abstract Trastuzumab combined with chemotherapy is standard of care for HER2 positive advanced gastro-esophageal cancers. The reported prevalence of HER2 discordance between primary tumors and corresponding metastases varies, hampering uniform patient selection for HER2 targeted therapy. This meta-analysis explores the influence of HER2 assessment methods on this discordance and investigates the prevalence of HER2 discordance in gastro-esophageal adenocarcinomas. PubMed, Embase and Cochrane databases were searched until January 2016. Differences in discordance rate between strict and broad(er) definitions of HER2 status were assessed using random-effect pair-wise meta-analysis. Random-effect single-arm meta-analyses were performed to assess HER2 discordance and the prevalence of positive and negative conversion. A significantly lower discordance rate in HER2 status between primary tumors and corresponding metastases was observed using a strict vs. broad definition of HER2 status (RR = 0.58, 95%CI 0.41–0.82), with a pooled discordance rate of 6.2% and 12.2%, respectively. Using the strict definition of HER2 assessment pooled overall discordance was 7% (95%CI 5–10%). The lowest discordance rates between primary tumors and corresponding metastasis are observed when using a strict method of HER2 positivity. Treatment outcomes of different studies will be better comparable if selection of eligible patients for HER2 targeted therapy is based on this strict definition.A. CreemersE. ter VeerL. de WaalP. LodderG. K. J. HooijerN. C. T. van GriekenM. F. BijlsmaS. L. MeijerM. G. H. van OijenH. W. M. van LaarhovenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q A. Creemers E. ter Veer L. de Waal P. Lodder G. K. J. Hooijer N. C. T. van Grieken M. F. Bijlsma S. L. Meijer M. G. H. van Oijen H. W. M. van Laarhoven Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis
description	Abstract Trastuzumab combined with chemotherapy is standard of care for HER2 positive advanced gastro-esophageal cancers. The reported prevalence of HER2 discordance between primary tumors and corresponding metastases varies, hampering uniform patient selection for HER2 targeted therapy. This meta-analysis explores the influence of HER2 assessment methods on this discordance and investigates the prevalence of HER2 discordance in gastro-esophageal adenocarcinomas. PubMed, Embase and Cochrane databases were searched until January 2016. Differences in discordance rate between strict and broad(er) definitions of HER2 status were assessed using random-effect pair-wise meta-analysis. Random-effect single-arm meta-analyses were performed to assess HER2 discordance and the prevalence of positive and negative conversion. A significantly lower discordance rate in HER2 status between primary tumors and corresponding metastases was observed using a strict vs. broad definition of HER2 status (RR = 0.58, 95%CI 0.41–0.82), with a pooled discordance rate of 6.2% and 12.2%, respectively. Using the strict definition of HER2 assessment pooled overall discordance was 7% (95%CI 5–10%). The lowest discordance rates between primary tumors and corresponding metastasis are observed when using a strict method of HER2 positivity. Treatment outcomes of different studies will be better comparable if selection of eligible patients for HER2 targeted therapy is based on this strict definition.
format	article
author	A. Creemers E. ter Veer L. de Waal P. Lodder G. K. J. Hooijer N. C. T. van Grieken M. F. Bijlsma S. L. Meijer M. G. H. van Oijen H. W. M. van Laarhoven
author_facet	A. Creemers E. ter Veer L. de Waal P. Lodder G. K. J. Hooijer N. C. T. van Grieken M. F. Bijlsma S. L. Meijer M. G. H. van Oijen H. W. M. van Laarhoven
author_sort	A. Creemers
title	Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis
title_short	Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis
title_full	Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis
title_fullStr	Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis
title_full_unstemmed	Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis
title_sort	discordance in her2 status in gastro-esophageal adenocarcinomas: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/256dfbed0fe34b36901003d0614a20f9
work_keys_str_mv	AT acreemers discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT eterveer discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT ldewaal discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT plodder discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT gkjhooijer discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT nctvangrieken discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT mfbijlsma discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT slmeijer discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT mghvanoijen discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis AT hwmvanlaarhoven discordanceinher2statusingastroesophagealadenocarcinomasasystematicreviewandmetaanalysis
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Discordance in HER2 Status in Gastro-esophageal Adenocarcinomas: A Systematic Review and Meta-analysis

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