Abstract
Objective:Human epidermal growth factor receptor 2 (erbb2/HER2) overexpression, has now been implicated in advanced gastric and gastroesophageal junction cancers. The study was conducted to determine the rate of HER2 positivity in patients with locally advanced or metastatic gastric and gastroesophageal adenocarcinoma in North-East India and to assess the impact of various demographic and clinical parameters on HER2 positivity. Methods:A total of 68 patients of age >18 years of gastric and gastroesophageal adenocarcinoma diagnosed on histopathological examination from September 2016 to February 2018 at Dr B Borooah Cancer Institute, Assam were enrolled for the observational (epidemiological) study. All patients were subjected to the HER2 immunohistochemistry test using a FDA-approved, standardized test kit. HER2 expression was correlated with various demographic and clinicopathological parameters. Results:The overall rate of HER2 positivity in the population studied was 56% (n=38). The rate was non-significantly higher in male, older age group (>60 years) and Hindu population. Similarly, HER2 positivity rate was higher in patients with well differentiated histology and was more common in patients with stage II and III diseases, but neither of the associations is statistically significant. HER2 positivity rate was significantly higher in proximal and in GEJ tumours (56% versus 44%, P=0.002). Conclusion: HER2 overexpression was evident in 56% of the North-East Indian patients with locally advanced and metastatic gastric and gastroesophageal adenocarcinoma. The overexpression correlated significantly with primary tumour site. Routine testing of gastric and gastroesophageal tumours for HER2 expression is recommended to provide a therapeutic advantage in Indian patients.
Highlights
Gastric cancer is a leading health-care problem worldwide and is the fifth most common cancer in the world, with 952,000 new cases diagnosed in 2012 Worldwide 0.7 million people die of gastric cancer each year [GLOBACON, 2012]
A total of 68 patients of age >18 years of gastric and gastroesophageal adenocarcinoma diagnosed on histopathological examination from September 2016 to February 2018 at Dr B Borooah Cancer Institute, Assam were enrolled for the observational study
Efficacy of trastuzumab in patients with breast cancer has led to emerging interest in its antitumor activity in patients with Human epidermal growth factor receptor 2 (HER2) positive gastric carcinoma
Summary
Gastric cancer is a leading health-care problem worldwide and is the fifth most common cancer in the world, with 952,000 new cases diagnosed in 2012 Worldwide 0.7 million people die of gastric cancer each year (accounts for 8.8% of all cancer-related deaths) [GLOBACON, 2012]. Gastric cancer is the second most common cancer among men and third-most among females in Asia (Rahman et al, 2014) and is the second most common cause of cancer-related deaths in India (Dikshit et al, 2012). A high incidence of gastric cancer has been reported from Southeast Asia, most commonly from Japan, China and South Korea (Ferlay et al, 2012). The age-adjusted rate (AAR) of gastric cancer among urban registries in India is (3.0-13.2) compared to the worldwide AAR (4.1-95.5) with China having the highest incidence of AAR. Amongst all the population based cancer registries in India, Papumpure district India) has the highest AAR of 50.2% followed by Aizawl district (Mizoram, India) with AAR of 43.9% both in males and females (ICMR 2016). The long term ingestion of high concentration of nitrates found in dried, smoked and salted foods appears to be associated with a higher risk in this part of the world
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