Journal Article

Prevalence and clinicopathological associations of HER2 expression in non-small cell lung cancer: a retrospective study in Jordanian patients

Sughayer, Maher, ALQudah, Mohammad, Abu Al Karsaneh, Ola, Al Anber, Arwa, AlMa’aitah, Hussien, Al-Mustafa, Sahar

2023

Overview

Background Human epidermal growth factor receptor 2 (HER2), a promising therapeutic target, can be mutated, amplified, or overexpressed in different malignancies, including non-small cell lung cancer (NSCLC). Although these alterations showed adverse prognostic effects in many cancers, their clinical significance in NSCLC is controversial. This study primarily assessed the prevalence of HER2 protein expression in NSCLC among Jordanian patients. In addition, the possible association between HER2 protein expression and clinicopathological variables was evaluated. Methods A total of 100 surgically resected NSCLC cases treated at King Hussein Cancer Center (KHCC) between 2009 and 2021 were examined for HER2 protein expression using immunohistochemistry (IHC). The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines for breast cancer were applied to interpret the results with a final score ranging from 0 to 3+, considering a score of 3 + as overexpression. Additionally, a separate subset of patients was tested for HER2 gene mutation. Fisher’s exact test was used to assess the association between HER2 scores and the other variables. Kaplan-Meier method was used to calculate survival. Results Of the 100 cases, Her2 overexpression (score 3+) was detected in 2 cases (2%), score 2 + in 10 cases (10%), score 1 + in 12 cases (12%), and score 0 in 76 cases (76%). The two positive cases were one adenocarcinoma and one squamous cell carcinoma; both patients were elderly male smokers. No significant association was identified between Her2 expression and age, gender, smoking, histological subtype, grade, stage, tumor size, and lymph node status. Our findings also showed no association between Her2 expression and survival; however, advanced tumor stages and positive lymph node metastasis were significantly associated with poor overall survival. All cases tested for the Her2 mutation were negative. Conclusions Her2 overexpression is uncommon in NSCLC among the Jordanian population. However, when the same scoring criteria are used, the rates are similar to other results found in Asian cohorts. Due to our study’s relatively small sample size, a larger one is required to investigate the prognostic value and the molecular associations between the different Her2 alterations.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adenocarcinoma / Aged / Antibodies / Breast cancer / Breast Neoplasms - pathology / Cancer / Cancer therapies / Carcinoma, Non-Small-Cell Lung - genetics / Chemotherapy / Epidermal growth factor / Epidermal growth factor receptor / ErbB-2 protein / Gene amplification / Gene mutations / Growth factors / Health aspects / HER2 / Humans / Immunohistochemistry / Jordan / Jordan - epidemiology / Kinases / Lung cancer / Lung cancer, Non-small cell / Lung cancer, Small cell / Lung Neoplasms - genetics / Lymph nodes / Male / Malignancy / Medical prognosis / Medical societies / Medicine / Medicine & Public Health / Metastases / Mutation / Non-small cell lung cancer / Non-small cell lung carcinoma / Oncology, Experimental / Pathology / Patients / Point mutation / Prevalence / Protein expression / Proteins / Receptor, ErbB-2 - genetics / Receptor, ErbB-2 - metabolism / Retrospective Studies / Small cell lung carcinoma / Smoking / Squamous cell carcinoma / Survival / Survival, Immunohistochemistry / Therapeutic targets / Tumors