Prognostic effect of epidermal growth factor receptor and EGFRvIII in glioblastoma multiforme patients

被引:369
作者
Heimberger, AB
Hlatky, R
Suki, D
Yang, D
Weinberg, J
Gilbert, M
Sawaya, R
Aldape, K
机构
[1] Univ Texas, MD Anderson Canc Ctr, Dept Neurosurg, Houston, TX 77030 USA
[2] Univ Texas, MD Anderson Canc Ctr, Dept Neurooncol, Houston, TX 77030 USA
[3] Univ Texas, MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USA
[4] Univ Texas, MD Anderson Canc Ctr, Brain Tumor Ctr, Houston, TX 77030 USA
关键词
D O I
10.1158/1078-0432.CCR-04-1737
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The epidermal growth factor receptor (EGFR) is overexpressed in similar to 50% to 60% of glioblastoma multiforme tumors, and the most common EGFR mutant, EGFRvIII, is expressed in 24% to 67% of cases. We sought to determine whether glioblastoma multiforme expression of either overexpressed wild-type EGFR or the mutant EGFRvIII is an independent predictor of overall patient survival. Experimental Design: Glioblastoma multiforme patients (n = 196) underwent a greater than or equal to 95% volumetric tumor resection followed by conformal radiation. Their EGFR and EGFRvIII status was determined by immunohistochemistry and survival analyses were done. Results: In our study of glioblastoma multiforme patients, 46% (n = 91) failed to express EGFR, 54% (n = 105) had overexpression of the wild-type EGFR, and 31% (n = 61) also expressed the EGFRvIII. Patients within groups expressing the EGFR, EGFRvIII, or lacking EGFR expression did not differ in age, sex, Karnofsky performance scale score, extent of tumor resection, or radiation. The median overall survival times for patients with tumors having EGFR expression absent, overexpressed only, or mutant (EGFRvIII) were 0.96, 0.98, and 1.07 years, respectively. However, for patients surviving greater than or equal to 1 year, these values were 2.03, 2.02, and 1.21 years (P < 0.0001; log-rank test comparing EGFRvIII with all others). This effect remained significant in the multivariate analysis after adjustment for all other cofactors including age and Karnofsky performance scale score (rate ratio 4.34; 95% confidence interval, 2.21-8.51). Conclusions: Neither the overexpressed wild-type EGFR nor EGFRvIII was an independent predictor of median overall survival in this selected cohort of patients who underwent extensive tumor resection. However, in patients surviving greater than or equal to 1 year, the expression of EGFRvIII was an independent negative prognostic indicator.
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页码:1462 / 1466
页数:5
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