Cancer Res Treat.  2015 Oct;47(4):549-554. 10.4143/crt.2014.362.

Epidermal Growth Factor Receptor Mutation Status in the Treatment of Non-small Cell Lung Cancer: Lessons Learned

• Lee DH
• Srimuninnimit V
• Cheng R
• Wang X
• Orlando M

• KMID: 2403370
• DOI: http://doi.org/10.4143/crt.2014.362

Abstract

Advances in oncology research have led to identification of tumor-specific biomarkers, some of which are important predictive indicators and ideal targets for novel therapeutics. One such biomarker in non-small cell lung cancer (NSCLC) is the epidermal growth factor receptor (EGFR). Patients with NSCLC who harbor an activating EGFR mutation show a more favorable response to treatment with an EGFR inhibitor, such as gefitinib, erlotinib, or afatinib, than to chemotherapy. The prevalence of EGFR mutations in East Asian patients is higher than that in other populations, and in some clinical settings, patients have been treated with EGFR inhibitors based on clinicopathologic characteristics with no information on EGFR status. However, based on results from a series of studies in which East Asian patients with advanced non-squamous NSCLC were treated with EGFR inhibitors alone or in combination with standard chemotherapy, this may not be the best practice because EGFR mutation status was found to be a key predictor of outcome. Data from these studies highlight the necessity of EGFR testing in determining the most suitable treatment for patients with advanced or metastatic NSCLC.

Keyword

Biological markers; Non-small-cell lung carcinoma; Epidermal growth factor receptor

MeSH Terms

Asian Continental Ancestry Group
Biological Markers
Carcinoma, Non-Small-Cell Lung*
Drug Therapy
Epidermal Growth Factor*
Humans
Practice Guidelines as Topic
Prevalence
Receptor, Epidermal Growth Factor*
Biological Markers
Epidermal Growth Factor
Receptor, Epidermal Growth Factor

Figure

• 

  Fig. 1. Waterfall plots of progression-free survival (A) and percentage change in lesion sum from baseline at best response (B) by epidermal growth factor receptor (EGFR) status in East Asian patients with non-small cell lung cancer who were treated with erlotinib monotherapy, pemetrexed monotherapy, or pemetrexed/erlotinib (unpublished data from Lee et al. [17]). (B) Change in the lesion sum was not calculable for one EGFR-negative patient in the pemetrexed treatment group.

• 

  Fig. 2. Waterfall plots of progression-free survival (A) and percentage change in lesion sum from baseline at best response (B) by epidermal growth factor receptor (EGFR) status in East Asian patients with non-small cell lung cancer who were treated with gefitinib monotherapy or pemetrexed-cisplatin/gefitinib maintenance therapy (unpublished data from Yang et al. [16]). (B) Change in the lesion sum was not calculable for two EGFR-positive patients in the pemetrexed-cisplatin/gefitinib treatment group and four EGFR-negative patients in the gefitinib monotherapy group.

Reference

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