Background

The epidermal growth factor receptor (EGFR) is a member of the ErbB family of membrane tyrosine-kinase receptors. Studies exploring the prognostic role of EGFR-overexpression in early breast cancer have shown variable results, and the true prognostic value of EGFR is unknown.

Methods

A systematic review of identified publications exploring the association between EGFR-overexpression (as defined from different techniques and cut-offs) and outcomes [disease-free (DFS) and, overall survival (OS)] in women with early breast cancer. The hazard ratios (HR) for DFS and OS were weighted and pooled in a meta-analysis using generic inverse variance and random effects modeling.

Results

Fifty-three studies comprising 21,418 women were included. EGFR-overexpression was found in 27% of the patients. Primary analysis included studies reporting HRs from multivariable analyses (10 studies including 4857 patients with HRs for OS and 17 studies comprising 8747 patients with HRs for DFS), EGFR-overexpression was associated with worse OS (HR 1.98, 95% CI: 1.59–2.47, p < .001) and DFS (HR 1.59, 95% CI 1.30–1.95, p < .001). The influence of EGFR overexpression on DFS was greater in women with triple negative tumors compared to women with non-triple negative tumors (HR 2.35 versus HR 1.45, respectively; p = .01). Analysis looking at odd ratios for both 5-year and 10-year for DFS and OS showed similar results.

Conclusion

EGFR-overexpression appears to be associated with reduced OS and DFS in women with early breast cancer. Patients with triple negative and EGFR-overexpression have poorer OS and DFS than those with triple negative tumors and normal EGFR expression.

中文翻译：

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早期乳腺癌中表皮生长因子受体的过表达和预后：系统评价和荟萃分析

背景

表皮生长因子受体（EGFR）是膜酪氨酸激酶受体ErbB家族的成员。探索EGFR过度表达在早期乳腺癌中的预后作用的研究显示出可变的结果，EGFR的真正预后价值尚不清楚。

方法

对已鉴定出版物的系统评价，探讨了早期乳腺癌女性中EGFR过表达（根据不同的技术和临界值定义）与预后[无疾病（DFS）和总体生存率（OS）]之间的关系。使用通用逆方差和随机效应模型对荟萃分析中DFS和OS的危险比（HR）进行加权和合并。

结果

纳入了21 418名妇女的53项研究。在27％的患者中发现EGFR过表达。初步分析包括通过多变量分析报告HR的研究（10项研究包括4857例OS的HR患者，以及17项研究8747例DFS的HR患者），EGFR过表达与OS恶化相关（HR 1.98，95％CI：1.59–2.47 ，p <.001）和DFS（HR 1.59，95％CI 1.30–1.95，p <.001）。与非三联阴性肿瘤的女性相比，三联阴性肿瘤的女性中EGFR过表达对DFS的影响更大（分别为HR 2.35和HR 1.45； p = 0.01）。分析DFS和OS的5年期和10年期的奇数比率的分析显示了相似的结果。

结论

EGFR过度表达似乎与早期乳腺癌女性的OS和DFS降低有关。具有三阴性和EGFR过表达的患者比具有三阴性和EGFR表达正常的患者的OS和DFS较差。