Prognostic biologic factors that can be assessed at the time of diagnosis f
or patients with osteogenic sarcoma have not been identified. The current s
tudy was designed to evaluate the prognostic significance of the human epid
ermal growth factor receptor 2 as it relates to histologic response to preo
perative chemotherapy and event-free survival. A retrospective immunohistoc
hemical study was performed on material from patients who were newly diagno
sed with osteogenic sarcoma who were treated according to the T12 protocol
from the authors' institution between 1986 to 1993. Staining for HER2/erbB-
2 was accomplished using standard monoclonal antibodies and methods. At the
time of initial biopsy, 42.6% of the samples showed HER2/erbB-2 overexpres
sion. Higher levels of expression were observed in samples from patients wi
th clinically detectable metastases at initial presentation and at relapse.
Expression of HER2/erbB-2 correlated with inferior event-free survival in
patients with non-metastatic disease (47% versus 79% at 5 years). In additi
on, HER2/erbB-2 expression was associated with significantly less tumor nec
rosis after preoperative chemotherapy as determined by the Huvos grading sy
stem. These data suggest that HER2/erbB-2 should be evaluated prospectively
as a prognostic indicator and clinical trials using antibodies that target
this receptor should be considered for the treatment of patients with oste
ogenic sarcoma.