HER2 amplification and clinicopathological characteristics in a large Asian cohort of rare mucinous ovarian cancer

PLoS One. 2013 Apr 19;8(4):e61565. doi: 10.1371/journal.pone.0061565. Print 2013.

Abstract

Mucinous epithelial ovarian cancer has a poor prognosis in the advanced stages and responds poorly to conventional chemotherapy. We aim to elucidate the clinicopathological factors and incidence of HER2 expression of this cancer in a large Asian retrospective cohort from Singapore. Of a total of 133 cases, the median age at diagnosis was 48.3 years (range, 15.8-89.0 years), comparatively younger than western cohorts. Most were Chinese (71%), followed by Malays (16%), others (9.0%), and Indians (5%). 24% were noted to have a significant family history of malignancy of which breast and gastrointestinal cancers the most prominent. Majority of the patients (80%) had stage I disease at diagnosis. Information on HER2 status was available in 113 cases (85%). Of these, 31 cases (27.4%) were HER2+, higher than 18.8% reported in western population. HER2 positivity appeared to be lower among Chinese and higher among Malays patients (p = 0.052). With the current standard of care, there was no discernible impact of HER2 status on overall survival. (HR = 1.79; 95% CI, 0.66-4.85; p = 0.249). On the other hand, positive family history of cancer, presence of lymphovascular invasion, and ovarian surface involvements were significantly associated with inferior overall survival on univariate and continued to be statistically significant after adjustment for stage. While these clinical factors identify high risk patients, it is promising that the finding of a high incidence of HER2 in our Asian population may allow development of a HER2 targeted therapy to improve the management of mucinous ovarian cancers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Mucinous / genetics*
  • Adenocarcinoma, Mucinous / pathology*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People / genetics*
  • Cohort Studies
  • Disease-Free Survival
  • Family
  • Female
  • Gene Amplification*
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / genetics*
  • Ovarian Neoplasms / pathology*
  • Receptor, ErbB-2 / genetics*
  • Singapore
  • Young Adult

Substances

  • ERBB2 protein, human
  • Receptor, ErbB-2

Grants and funding

This study was supported by the Khoo Discovery Award (KDP/2008/0002 and KDP/2009/0006) and Duke-NUS Signature Research Program Phase 1 funded by the Agency for Science, Technology and Research (A*STAR), and the Ministry of Health, Singapore, awarded to LKG. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.