Does HER2/neu expression provide prognostic information in patients with advanced urothelial carcinoma?
This study of HER2 expression in bladder carcinoma focused on patients who were treated prospectively in a standardized fashion, unlike prior studies that have evaluated banked, archival specimens. The authors confirmed the findings of others that high-grade, muscle-invasive urothelial carcinoma of the bladder has a significant rate of HER2 expression (71%). However, contrary to other reports, the current study found that HER2 expression in the context of paclitaxel-based chemotherapy decreased the risk of death significantly. Further research is warranted on the possible association of HER2 expression with chemosensitivitiy in urothelial carcinoma as well as the efficacy of HER2-targeted therapies (such as trastuzumab) for patients with high-grade, muscle-invasive urothelial carcinoma of the bladder.
Cancers of the upper third of the rectum have more similarities with rectal cancers of the middle third of the rectum than with sigmoid cancers. A subgroup of patients with upper third rectal cancer can be identified who may require a more aggressive therapy than only primary resection followed by adjuvant therapy.