The growth factor receptors HER-2/neu and EGFR, their relationship, and their effects on the prognosis in early stage (FIGO I-II) epithelial ovarian carcinoma

Epithelial ovarian canter is a heterogeneous disease and many biologic and molecular factors are important for its development and progression, includ ing growth rate, metastatic potential, chemo- and radiosensitivity, and pro gnosis. Even in the early stages (FIGO I-II), many questions persist about the biologic behavior, optimal treatment, and prognosis. In a series of 106 patients with epithelial ovarian cancers in FIGO stages IA-IIC, a number of known prognostic factors (age, FIGO stage, histopatholo gic type, and tumor grade) were studied in relation to two important growth factor receptors for oncogenesis (HER-2/neu and EGFR). Immunohistochemical techniques were used. All patients received adjuvant radiotherapy 4-6 week s after the primary surgery. In a univariate analysis, the expression of th e HER-2/neu receptor was not associated with any of the clinicopathologic f actors studied or survival status. Positive EGFR staining was associated wi th poor survival in a univariate analysis. Co-expression of HER-2/neu and E GFR was most frequently seen in serous tumors and positive staining for HER -2/neu alone was associated with mucinous tumors. Both endometrioid and cle ar cell tumors belonged to the largest subgroup with concomitant negativity for both HER-2/neu and EGFR. In a multivariate Cox analysis, the tumor gra de and EGFR status of the tumors were independent and significant prognosti c factors. A therapeutic strategy for epithelial ovarian cancer might be to decrease EGFR expression by gene therapy in combination with adjuvant radi otherapy or chemotherapy.