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Response to gefitinib and erlotinib in non-small cell lung cancer: a retrospective study
BMC Cancer, 09/22/09

Emery IF et al. – Tumor cells that have activated EGFR pathways, presumably being utilized for survival, are clinically relevant targets for pathway inhibition.

Methods

Outcome data of a population of NSCLC patients that received TKIs to determine the benefit derived and to define the clinical and molecular parameters that correlate with response were analyzed
Tumor tissue from a subgroup of these patients was analyzed by immunohistochemistry to measure the expression level of EGFR and four activated (phosphorylated) members of the pathway, pEGFR, pERK, pAKT, and pSTAT3

Results

Erlotinib was slightly superior to gefitinib in all measures of response, although the differences were not statistically significant
The most robust clinical predictors of time to progression (TTP) were best response and rash
A higher tumor level of pEGFR was associated with longer TTP, while the total EGFR level was not associated with response
Higher tumor levels of pAKT and pSTAT3 were also associated with longer TTP
A higher level of pERK1/2 was associated with shorter TTP

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