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The role of HER-2/neu expression on the survival of patients with lung cancer: a systematic review of the literature.

Meert AP, Martin B, Paesmans M, Berghmans T, Mascaux C, Verdebout JM, Delmotte P, Lafitte JJ, Sculier JP - Br. J. Cancer (2003)

Bottom Line: Significant studies had a better subscore relative to analysis and results report than nonsignificant studies.For NSCLC, the hazard ratio was 1.55 (95% CI: 1.29-1.86) in favour of tumours that do not express c-erbB-2.In conclusion, the overexpression of c-erbB-2 might be a factor of poor prognosis for survival in NSCLC, but there is a potential bias in favour of the significant studies with an overestimation risk of the magnitude of the true effect of c-erbB-2 overexpression.

View Article: PubMed Central - PubMed

Affiliation: Fonds National de la Recherche Scientifique, Bruxelles, Belgium. ap.meert@bordet.be

ABSTRACT
C-erbB-2 prognostic value for survival in patients with lung cancer remains controversial. We performed a systematic review of the literature to clarify its impact. Studies were identified by an electronic search in order to aggregate the survival results, after a methodological assessment using the scale of the European Lung Cancer Working Party. To be eligible, a study had to deal with c-erbB-2 assessment in lung cancer patients and to analyse survival according to c-erbB-2 expression. In total, 30 studies were eligible: 24 studies dealt with non-small-cell lung carcinoma (NSCLC), five with adenocarcinoma and one study dealt with small-cell carcinoma. In all, 31% of the patients were positive for c-erbB-2. According to c-erbB-2 expression, 13 studies were 'negative' (significant detrimental effect on survival), one 'positive' (significant survival improvement) and 16 not significant. Significant studies had a better subscore relative to analysis and results report than nonsignificant studies. In total, 86% of the significant studies and only 56% of the nonsignificant studies were evaluable for the meta-analysis. This suggests a possible bias in our aggregated results. For NSCLC, the hazard ratio was 1.55 (95% CI: 1.29-1.86) in favour of tumours that do not express c-erbB-2. In conclusion, the overexpression of c-erbB-2 might be a factor of poor prognosis for survival in NSCLC, but there is a potential bias in favour of the significant studies with an overestimation risk of the magnitude of the true effect of c-erbB-2 overexpression.

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Results of the meta-analysis of all the studies. Ardizzoni et al (2001); Brabender et al (2001); Cantero et al, (2000); D'Amico et al (1999); Giatromanolaki et al (1996a), (1996b); Han et al (2002); Harpole et al (1996); Hirsch et al (2002); Hsieh et al (1998); Kern et al (1990) (adc); Kern et al (1990) (sq); Kim et al (1998); Kwiatkowski et al (1998); Liao et al (2001); Moldvay et al (2000) (adc); Moldvay et al (2000) (sq); Pastorino et al (1997); Pfeiffer et al (1996); Selvaggi et al (2002); Shou et al (2001); Tateishi et al (1994); Yu et al (1997); HR>1 implies a worse survival for the group with c-erbB2 expression. The square size is proportional to the number of patients included in the study. The centre of the lozenge gives the combined HR for the meta-analysis and its extremities give the 95% CI.
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fig1: Results of the meta-analysis of all the studies. Ardizzoni et al (2001); Brabender et al (2001); Cantero et al, (2000); D'Amico et al (1999); Giatromanolaki et al (1996a), (1996b); Han et al (2002); Harpole et al (1996); Hirsch et al (2002); Hsieh et al (1998); Kern et al (1990) (adc); Kern et al (1990) (sq); Kim et al (1998); Kwiatkowski et al (1998); Liao et al (2001); Moldvay et al (2000) (adc); Moldvay et al (2000) (sq); Pastorino et al (1997); Pfeiffer et al (1996); Selvaggi et al (2002); Shou et al (2001); Tateishi et al (1994); Yu et al (1997); HR>1 implies a worse survival for the group with c-erbB2 expression. The square size is proportional to the number of patients included in the study. The centre of the lozenge gives the combined HR for the meta-analysis and its extremities give the 95% CI.

Mentions: When considering only the 20 studies evaluating survival in NSCLC, the test of heterogeneity was significant (P=0.001). Thus, we calculated the HR using a random-effects model and obtained a value that was statistically significant: HR=1.55 (95% CI: 1.29–1.86) (Figure 1Figure 1


The role of HER-2/neu expression on the survival of patients with lung cancer: a systematic review of the literature.

Meert AP, Martin B, Paesmans M, Berghmans T, Mascaux C, Verdebout JM, Delmotte P, Lafitte JJ, Sculier JP - Br. J. Cancer (2003)

Results of the meta-analysis of all the studies. Ardizzoni et al (2001); Brabender et al (2001); Cantero et al, (2000); D'Amico et al (1999); Giatromanolaki et al (1996a), (1996b); Han et al (2002); Harpole et al (1996); Hirsch et al (2002); Hsieh et al (1998); Kern et al (1990) (adc); Kern et al (1990) (sq); Kim et al (1998); Kwiatkowski et al (1998); Liao et al (2001); Moldvay et al (2000) (adc); Moldvay et al (2000) (sq); Pastorino et al (1997); Pfeiffer et al (1996); Selvaggi et al (2002); Shou et al (2001); Tateishi et al (1994); Yu et al (1997); HR>1 implies a worse survival for the group with c-erbB2 expression. The square size is proportional to the number of patients included in the study. The centre of the lozenge gives the combined HR for the meta-analysis and its extremities give the 95% CI.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376951&req=5

fig1: Results of the meta-analysis of all the studies. Ardizzoni et al (2001); Brabender et al (2001); Cantero et al, (2000); D'Amico et al (1999); Giatromanolaki et al (1996a), (1996b); Han et al (2002); Harpole et al (1996); Hirsch et al (2002); Hsieh et al (1998); Kern et al (1990) (adc); Kern et al (1990) (sq); Kim et al (1998); Kwiatkowski et al (1998); Liao et al (2001); Moldvay et al (2000) (adc); Moldvay et al (2000) (sq); Pastorino et al (1997); Pfeiffer et al (1996); Selvaggi et al (2002); Shou et al (2001); Tateishi et al (1994); Yu et al (1997); HR>1 implies a worse survival for the group with c-erbB2 expression. The square size is proportional to the number of patients included in the study. The centre of the lozenge gives the combined HR for the meta-analysis and its extremities give the 95% CI.
Mentions: When considering only the 20 studies evaluating survival in NSCLC, the test of heterogeneity was significant (P=0.001). Thus, we calculated the HR using a random-effects model and obtained a value that was statistically significant: HR=1.55 (95% CI: 1.29–1.86) (Figure 1Figure 1

Bottom Line: Significant studies had a better subscore relative to analysis and results report than nonsignificant studies.For NSCLC, the hazard ratio was 1.55 (95% CI: 1.29-1.86) in favour of tumours that do not express c-erbB-2.In conclusion, the overexpression of c-erbB-2 might be a factor of poor prognosis for survival in NSCLC, but there is a potential bias in favour of the significant studies with an overestimation risk of the magnitude of the true effect of c-erbB-2 overexpression.

View Article: PubMed Central - PubMed

Affiliation: Fonds National de la Recherche Scientifique, Bruxelles, Belgium. ap.meert@bordet.be

ABSTRACT
C-erbB-2 prognostic value for survival in patients with lung cancer remains controversial. We performed a systematic review of the literature to clarify its impact. Studies were identified by an electronic search in order to aggregate the survival results, after a methodological assessment using the scale of the European Lung Cancer Working Party. To be eligible, a study had to deal with c-erbB-2 assessment in lung cancer patients and to analyse survival according to c-erbB-2 expression. In total, 30 studies were eligible: 24 studies dealt with non-small-cell lung carcinoma (NSCLC), five with adenocarcinoma and one study dealt with small-cell carcinoma. In all, 31% of the patients were positive for c-erbB-2. According to c-erbB-2 expression, 13 studies were 'negative' (significant detrimental effect on survival), one 'positive' (significant survival improvement) and 16 not significant. Significant studies had a better subscore relative to analysis and results report than nonsignificant studies. In total, 86% of the significant studies and only 56% of the nonsignificant studies were evaluable for the meta-analysis. This suggests a possible bias in our aggregated results. For NSCLC, the hazard ratio was 1.55 (95% CI: 1.29-1.86) in favour of tumours that do not express c-erbB-2. In conclusion, the overexpression of c-erbB-2 might be a factor of poor prognosis for survival in NSCLC, but there is a potential bias in favour of the significant studies with an overestimation risk of the magnitude of the true effect of c-erbB-2 overexpression.

Show MeSH
Related in: MedlinePlus