TY - JOUR
T1 - Prognostic effect of epidermal growth factor receptor and EGFRvIII in glioblastoma multiforme patients
AU - Heimberger, Amy B.
AU - Hlatky, Roman
AU - Suki, Dima
AU - Yang, David
AU - Weinberg, Jeff
AU - Gilbert, Mark
AU - Sawaya, Raymond
AU - Aldape, Kenneth
PY - 2005/2/15
Y1 - 2005/2/15
N2 - Purpose: The epidermal growth factor receptor (EGFR) is overexpressed in ∼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 ≥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 ≥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 ≥1 year, the expression of EGFRvIII was an independent negative prognostic indicator.
AB - Purpose: The epidermal growth factor receptor (EGFR) is overexpressed in ∼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 ≥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 ≥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 ≥1 year, the expression of EGFRvIII was an independent negative prognostic indicator.
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U2 - 10.1158/1078-0432.CCR-04-1737
DO - 10.1158/1078-0432.CCR-04-1737
M3 - Article
C2 - 15746047
AN - SCOPUS:14644412873
SN - 1078-0432
VL - 11
SP - 1462
EP - 1466
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 4
ER -