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Validated clinico-pathologic nomogram in the prediction of HER2 status in gastro-oesophageal cancer

BACKGROUND: HER2 is the only validated predictive biomarker in gastro-oesophageal carcinoma (GOC). However, several factors, such as heterogeneity in protein expression, shortage of evaluable tumour tissue and need for quick target assessment, underline the usefulness of a pre-screening tool in orde...

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Detalles Bibliográficos
Autores principales: Fornaro, Lorenzo, Vivaldi, Caterina, Parnofiello, Annamaria, Ugolini, Clara, Aprile, Giuseppe, De Maglio, Giovanna, Pecora, Irene, Iacono, Donatella, Crivelli, Francesca, Catanese, Silvia, Cardellino, Giovanni Gerardo, Lencioni, Monica, Vasile, Enrico, Salani, Francesca, Clerico, Mario, Calvetti, Lorenzo, Falcone, Alfredo, Fasola, Gianpiero, Fontanini, Gabriella, Montagnani, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461920/
https://www.ncbi.nlm.nih.gov/pubmed/30745584
http://dx.doi.org/10.1038/s41416-019-0399-4
Descripción
Sumario:BACKGROUND: HER2 is the only validated predictive biomarker in gastro-oesophageal carcinoma (GOC). However, several factors, such as heterogeneity in protein expression, shortage of evaluable tumour tissue and need for quick target assessment, underline the usefulness of a pre-screening tool in order to anticipate HER2 status. METHODS: Data from 723 consecutive GOC analysed for HER2 at four Italian Institutions were collected. HER2 positivity was defined as 3+ by immunohistochemistry (IHC) or 2+ with gene amplification by in situ hybridisation (ISH). A multivariate logistic regression model was built using data from 413 cases, whereas 310 patients served as validation cohort. C-index, visual inspection of the calibration plot, Brier score and Spiegelhalter z-test were used to assess the performance of the nomogram. RESULTS: HER2 positive rate was 17.4%. Four variables were retained after adjustment in the final model: grading, Lauren’s histotype, pathologic material analysed (surgical specimen/biopsy) and site of tissue collection (primary tumour/metastases). Visual inspection of the calibration plot revealed a very good overlap between predicted and observed probabilities, with a Brier score of 0.101 and a non-significant Spiegelhalter z-test (P = 0.319). C-index resulted in 0.827 (95%CI 0.741–0.913). CONCLUSION: A simple nomogram based on always-available pathologic information accurately predicts the probability of HER2 positivity in GOC.