Correlation between c-erbB-4 receptor expression and response to gemcitabine-cisplatin chemotherapy in non-small-cell lung cancer.

Background:While the overexpression of c-erbB gene family inseveral malignancies is associated with poorer prognosis, the associationbetween the expression of the cellular markers and the response tochemotherapy is not yet clear. In this study we investigated the expressionof c-erbB-4 receptor in NSCLC and correlated it with the response togemcitabine–cisplatin combination chemotherapy.Patients and methods:Forty-three NSCLC patients withhistologically or cytologically proven disease were treated withgemcitabine–cisplatin combination chemotherapy. Immunohistochemicalstains for c-erbB-4 receptor were performed in 20 cases on paraffin sectionsusing the avidin-biotin-peroxidase method.Results:Two patients achieved complete response (5%), and16 achieved partial response (37%) yielding an overall objectiveresponse rate of 42%. Minimal response was observed in seven patients(16%) and disease stabilization in 7%. Immunohistochemical stainwas positive for the presence of c-erbB-4 receptor in 25% of patients,and negative in 75%. No response was documented in c-erbB-4 positivepatients (0 of 5) while an objective response (complete, partial orminimal) was seen in 11 of 15 (73%) c-erbB-4 negative patients.Negative stain for c-erbB-4 significantly favored response togemcitabine–cisplatin combination (P < 0.01).Conclusion:C-erbB-4 expression status showed no correlation withsurvival and cannot be accepted at this time as a guiding factor fortherapeutic management. These interesting results deserve further evaluationin a large-scale prospective trial before treatment recommendations on thebasis of c-erbB-4 presence can be finally made.