Human epidermal growth factor receptor 2 as a prognostic indicator in osteogenic sarcoma

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.