ArticleUrology research & practice2026
Targeting Human Epidermal Growth Factor Receptor 2 in Bladder Cancer: Evaluating Its Role as a More Robust Clinicopathological Biomarker Compared to Programmed Death Ligand 1 Expression.
Article in Urology research & practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This retrospective cross-sectional analytical study evaluated the clinicopathological associations of programmed death ligand 1 (PD-L1) and human epidermal growth factor receptor 2 (HER2/neu) expression in 250 patients with urothelial carcinoma of the urinary bladder, with particular emphasis on their relationship to tumor stage and lymph node involvement.
methodsA retrospective observational study was conducted on 250 patients with urothelial carcinoma who underwent immunohistochemical evaluation of PD-L1, using a tumor proportion score (TPS) of ≥1%, and HER2/neu with 3+ considered positive. Formalin-fixed paraffin-embedded tissue from transurethral resection of bladder tumor and cystectomy specimens was analyzed by immunohistochemistry. The HER2/ neu was scored using a standard 0-3+ system, and PD-L1 expression was assessed by TPS. Associations were tested using chi-square or Fisher's exact tests. Multivariable logistic regression evaluated whether HER2/neu independently predicted nodal involvement after adjustment for age, sex, tumor stage, and morphology. Statistical significance was set at P < .05.
resultsThe HER2/neu 3+ positivity was present in 100/250 patients (40%) and was significantly associated with nodal involvement (P = .019). On multivariable logistic regression, HER2/neu is independently associated with nodal involvement, reflecting aggressive tumor biology (adjusted OR 2.41; 95% CI 1.33-4.36; P = .004). Among node-negative patients (N0, n = 200), 35.5% were HER2/neu positive, rising stepwise to 50.0% in N1, 54.5% in N2, and 71.4% in N3 disease, supporting a relationship between HER2/ neu overexpression and nodal progression. In contrast, PD-L1 positivity (TPS ≥1%) was observed in 129/250 patients (51.6%) and was not significantly associated with age, sex, tumor stage, nodal status, grade, multiplicity, or morphology (all P > .05).
conclusionThe HER2/neu was an independent clinicopathological biomarker associated with nodal involvement and aggressive tumor biology in urothelial carcinoma. PD-L1 showed limited clinicopathological utility in this cohort, though it retains predictive value for immune checkpoint inhibitor therapy. Cite this article as: Mittal A, Malhotra K, Panwar V, Kishore S, Taher M, Singhal A. Targeting human epidermal growth factor receptor 2 in bladder cancer: evaluating its role as a more robust clinicopathological biomarker compared to programmed death ligand 1 expression. Urol Res Pract. 2026, 52, 0061, doi: 10.5152/tud.2026.25061.
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