Ml. Simmons et al., Analysis of complex relationships between age, p53, epidermal growth factor receptor, and survival in glioblastoma patients, CANCER RES, 61(3), 2001, pp. 1122-1128
Glioblastoma multiforme (GBM) carries a dismal prognosis. However, a range
of survival times exists, and parameters that define prognostic groups may
help to optimize treatment. To identify such prognostic groups, we analyzed
tumor tissue from 110 cases of newly diagnosed GEM from two clinical proto
cols. Similar to other studies, we found no association of epidermal growth
factor receptor (EGFR) overexpression (as assessed by immunohistochemistry
), p53 immunopositivity, or p53 mutation with survival in the entire sample
, However, EGFR overexpression showed trends toward worse prognosis in pati
ents younger than the median age, but better prognosis in patients older th
an the median age. This interaction of EGFR with age group was statisticall
y significant and led us to focus our further analyses on the younger patie
nts. In this group, a statistically significant association of EGFR overexp
ression with worse survival was identified in the p53-negative but not p53-
positive tumors. We found a similar result after screening these cases for
mutations in p53: EGFR overexpression was negatively associated with surviv
al only in the p53 wild-type cases. To confirm this unexpected result, this
finding was reproduced in a validation sample of an additional 42 tumors f
rom younger patients on the same two clinical protocols. This complex relat
ionship between EGFR and p53 in younger patients remained in a multivariate
analysis that incorporated additional prognostic variables. The results su
ggest that analysis of prognostic markers in GEM is complex, and maximal in
formation may require analysis of subgroups based on age and the status of
specific markers such as p53, In addition, they suggest a specific group of
patients on which to focus promising therapies targeting EGFR.