# The TMPRSS2-ERG rearrangement, ERG expression and prostate cancer outcomes: a cohort study and meta-analysis

Source: https://onco.cc/key-papers/paper-pettersson-tmprss2-erg-outcome-meta-analysis-cebp-2012/  
OnCo record `paper-pettersson-tmprss2-erg-outcome-meta-analysis-cebp-2012` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Following 1,180 men for more than twelve years, and then pooling 48 other studies, found that the commonest genetic change in prostate cancer does not predict who does badly.

## Summary

Among men with prostate cancer in the prospective Physicians' Health Study and Health Professionals Follow-Up Study, rearrangement status was determined by immunohistochemical assessment of ERG protein expression, and Cox models examined associations with biochemical recurrence and lethal disease, defined as distant metastases or cancer-specific mortality. The cohort consisted of 1,180 men treated with radical prostatectomy between 1983 and 2005; during a median follow-up of 12.6 years, 266 men experienced recurrence and 85 developed lethal disease. There was no significant association between ERG overexpression and biochemical recurrence, hazard ratio 0.99, or lethal disease, hazard ratio 0.93. A meta-analysis including 47 additional studies covered 5,074 men followed for biochemical recurrence with 1,623 events and 2,049 men followed for lethal disease with 131 events; TMPRSS2-ERG was associated with stage at diagnosis, risk ratio 1.23 for T3 or above against T2, but not with biochemical recurrence, risk ratio 1.00, or lethal disease, risk ratio 0.99.

## Fields

- Kind: Key paper
- Last checked: 2026-09-25
- Journal: Cancer Epidemiology, Biomarkers and Prevention
- Year: 2012
- DOI: 10.1158/1055-9965.EPI-12-0042
- Authors: Pettersson A, Graff RE, Bauer SR, et al.
- Findings: No association between ERG overexpression and biochemical recurrence, hazard ratio 0.99, in 1,180 men followed a median 12.6 years.; No association with lethal disease, hazard ratio 0.93.; Meta-analysis over 48 studies: risk ratio 1.00 for recurrence and 0.99 for lethal disease.; An association with stage at diagnosis, risk ratio 1.23.
- What it means: It is the definitive negative result for the commonest genomic alteration in this disease. A man told his tumour carries the TMPRSS2-ERG fusion should be told plainly that it does not make his cancer more dangerous.
- Caveats: Surgical cohorts, so it describes men treated with prostatectomy rather than all comers.; ERG immunohistochemistry is a proxy for the rearrangement rather than the rearrangement itself.; Meta-analysis over studies with different assays and different endpoints.

## Sources

- Pettersson et al., Cancer Epidemiol Biomarkers Prev 2012: TMPRSS2-ERG, ERG expression and outcome in a 1,180-man cohort and a meta-analysis of 48 studies: https://doi.org/10.1158/1055-9965.EPI-12-0042
- PubMed: https://pubmed.ncbi.nlm.nih.gov/22736790/

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Histopathology & immunohistochemistry](https://onco.cc/technologies/histopathology-ihc/)
- targets: [ERG](https://onco.cc/targets/erg/), [TMPRSS2](https://onco.cc/targets/tmprss2/)
- pathways: [Androgen receptor signalling](https://onco.cc/pathways/ar-signaling/), [Prostate cancer (KEGG map)](https://onco.cc/pathways/prostate-cancer-signalling/)
- terms: [Biochemical recurrence (BCR)](https://onco.cc/terms/biochemical-recurrence/), [Gene fusion](https://onco.cc/terms/gene-fusion/), [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/)
- journals: [Cancer Epidemiology, Biomarkers & Prevention](https://onco.cc/journals/cancer-epidemiology-biomarkers-prevention/)
- biomarkers: [TMPRSS2-ERG fusion (and the other ETS rearrangements)](https://onco.cc/biomarkers/tmprss2-erg-fusion/)

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