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. 2012:2012:181964.
doi: 10.1155/2012/181964. Epub 2012 Sep 9.

Clinical Significance of ErbB Receptor Family in Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-Analysis

Yuh-Shyan Tsai  1 , Hong-Lin Cheng, Tzong-Shin Tzai, Nan-Haw Chow
Affiliations

Clinical Significance of ErbB Receptor Family in Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-Analysis

Yuh-Shyan Tsai et al. Adv Urol. 2012.

Abstract

The prognostic importance of examining ErbB receptor family expression in human bladder cancer remains uncertain. Using published evidence, we examined the clinical value and the updated results of clinical trials targeting ErbB receptor family members. Twenty-seven articles from 65 references related to ErbB receptor expression assessment in bladder cancer were reviewed. The estimates included the association significance, hazard ratios, and 95% confidence intervals (CIs) from actuarial curves and survival analyses. A meta-analysis was done on those reports using univariate log-rank tests or a Cox-regression model. The methods of analysis and study subjects chosen varied widely among studies. The overall risks of disease progression for patients with EGFR or ErbB2 overexpression were 4.5 (95% CI: 2.5-8.4) and 1.1 (95% CI: 0.6-1.9), and the risks of mortality were 3.0 (95% CI: 1.6-5.9) and 1.1 (95% CI: 1.0-1.2), respectively. However, the significance of coexpression patterns of the ErbB receptor family remains controversial. None of six clinical trials yielded convincing results for blockading ErbB receptor signaling in urothelial carcinoma. The results of this analysis suggest that assessing co-expression patterns of the ErbB family may provide better prognostic information for bladder cancer patients.

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Figures

Figure 1
Figure 1
Forest plots of studies on the prognostic significance of EGFR and ErbB2 overexpression in bladder cancer. (a) The effect on recurrence. (b) The effect of EGFR (A) or ErbB2 (B) on progression. Hazard ratios and 95% (confidence intervals) CIs for patients with either EGFR- or ErbB2-positive tumors.
Figure 2
Figure 2
Forest plots of prognostic significance of EGFR and ErbB2 overexpression on bladder cancer death. (a) EGFR. (b) ErbB2. Hazard ratios and 95% (confidence intervals) CIs for patients with either EGFR- or ErbB2-positive tumors.
Figure 3
Figure 3
Funnel plots of publication bias for EGFR and ErbB2. (a) No obvious funnel plot asymmetry was found for EGFR because only four studies were analyzed. (b) A substantial funnel plot asymmetry for ErbB2 was found, which suggests the existence of publication bias.
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