Abstract
BackgroundThe reported rates of HER2 positivity in uterine cervical cancer (CC) range from 0–87%. The organization of clinical studies of HER2 targeting agents in CC requires a better knowledge of HER2 positivity prevalence. We aimed to provide precise estimates of HER2 overexpression and amplification in CC.MethodsWe conducted a PRISMA compliant meta-analytic systematic review. We searched electronic databases for articles reporting the proportion of HER2 positivity by immunohistochemistry or in situ hybridization in CC. We performed descriptive analyses of all 65 included studies. Of these, we selected 26 studies that used standardized American Society of Clinical Oncology / College of American Pathologists (ASCO/CAP) Guidelines compliant methodology. We conducted several meta-analyses of proportions to estimate the pooled prevalence of HER2 positivity and subgroup analyses using geographic region, histology, tumor stage, primary antibody brand, study size, and publication year as moderators.ResultsThe estimated pooled prevalence of HER2 overexpression was 5.7% (CI 95%: 1.5–11.7%) in ASCO/CAP compliant studies and 27.0%, (CI 95%: 19.9–34.8%) in ASCO/CAP non-compliant ones, p < 0.001. The estimated pooled prevalence of HER2 amplification was 1.2% (CI 95%: 0.0–5.8%) and 24.9% (CI 95%: 12.6–39.6%), respectively, p = 0.004. No other factor was significantly associated with HER2 positivity rates.ConclusionA small proportion of CC is expected to be HER2 positive. Variations in previously reported HER2 positivity rates are mainly related to methodological issues.
Prognostic value of post-treatment18F-fluorodeoxyglucose positron emission tomography in uterine cervical cancer patients treated with radiotherapy: a systematic review and meta-analysis