Publication Year: 2000 Visited: 125

372

C-erbB2 as a Prognostic Factor in Breast Cancer (BC): A Meta-Analysis. Bruce J Trock, Hideko Yamauchi, Michelle Brotzman, Vered Stearns, Daniel F Hayes, Lombardi Cancer Ctr, Georgetown Univ, Washington, DC.

More than ten years since the initial publication evaluating the prognostic role of c-erbB2 in BC, its clinical utility is still not clearly established. This is due in part to variability in the methods and rigor of tumor marker studies and the emerging understanding of the difference between prognosis and prediction. To evaluate the pure prognostic value of c-erbB2, only patients (pts) who did not receive adjuvant systemic therapy (AST) should be included. We conducted a meta-analysis to evaluate the pure prognostic role of c-erbB2 in BC. Methods. We identified studies that investigated c-erbB2 in BC through Medline and Pubmed, including the references listed in the individual manuscripts, and abstracts from the 1997-1999 ASCO and AACR meetings. Results. Excluding studies where all pts received AST, we identified 124 studies of c-erbB2 and prognosis in BC. Of these, 94 (76%) failed to denote whether AST was given, or if so to whom, leaving 30 studies (7041 pts without AST) in the analysis. However, for each endpoint, only approximately half of the studies provided adequate quantitative data that could be pooled for an estimate of relative risk (RR) and 95% confidence interval (CI). {table}Conclusions.The studies demonstrated enormous variability in methods, patient populations, and results. Although the 95% CIs exclude 1.0 for all of the pooled RRs, the magnitudes of the RRs are small and suggest little or no clinically relevant prognostic effect. These findings show that current data do not support the use of c-erbB2 as a pure prognostic factor in BC. However, the variability of results, exclusion of studies where AST use was unclear, and the lack of adequate data from many studies underscore the need for methodologically rigorous and consistent studies to allow a more thorough assessment.