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Concomitant expression of HER2 and HIF-1α is a predictor of poor prognosis in uterine cervical carcinoma treated with concurrent chemoradiotherapy: prospective analysis (KGROG0501)
Y. Niibe1,*, J. Watanabe2, S. Tsunoda3, M. Arai3, T. Arai3, M. Kawaguchi3, K. Matsuo4, T. Jobo5, S. Ono3, A. Numata3, N. Unno3, K. Hayakawa1
1 Department of Radiation Oncology, Kitasato University School of Medicine
2 Department of Pathology, Kitasato University School of Medicine
3 Department of Obstetrics and Gynecology, Kitasato University School of Medicine
4 Division of Epidemiology and Prevention, Aichi Cancer Center
5 Gynecological Oncology Center, Social Insurance Sagamino Hospital, Sagamihra, Kanagawa (Japan)
Eur. J. Gynaecol. Oncol. 2010, 31(5), 491–496;
Published: 10 October 2010
Background: In previously reported retrospective analyses of uterine cervical carcinoma cases, HER2 was correlated with poor radiation sensitivity and poor treatment outcomes and HIF-1α was found to be an indicator of poor prognosis. To date, no prospective studies have been performed to evaluate the radiation sensitivity and treatment outcomes of patients with uterine cervical carcinoma relative to HER2 and HIF-1α expressions. We conducted a prospective evaluation of HER2 and HIF-1α in cases of locally advanced uterine cervical carcinoma treated with concurrent chemoradiotherapy. Methods: Between June 2005 and April 2008, 25 patients with locally advanced uterine cervical carcinoma were registered in this study, KGROG0501. Their clinical stages were Ib2/IIb/IIIb/IVa in 1/2/22/1 cases, respectively. Nineteen cases had squamous cell carcinoma and six had adenocarcinoma. HER2 expression and HIF-1α expression were analyzed using an immunohistochemical kit on pretreatment biopsied specimens. HIF-1α expression was studied using another commercial immunohistochemical kit on pretreatment biopsied specimens. The survival rates were compared between patients with and without positive HER2 and HIF-1α expressions. Results: The 20-month survival of HER2(-) and HIF-1α(-) cases (n = 6) was 100% and that of HER2(+) and HIF-1α(+) cases (n = 4) was 37.5% (p = 0.0032). Conclusions: In this first prospective analysis of patients with uterine cervical carcinoma treated with concurrent chemoradiotherapy, concomitant expression of HER2 and HIF-1α was suggested to be a strong indicator of poor prognosis. A novel therapy including molecular targeted therapy such as anti-HER2 and anti-HIF-1α may be worth considering in patients with concomitant expression of HER2 and HIF-1α.
Uterine cervical carcinoma