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Review
. 2015 Oct;47(4):549-54.
doi: 10.4143/crt.2014.362. Epub 2015 Apr 29.

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

Dae Ho Lee  1 , Vichien Srimuninnimit  2 , Rebecca Cheng  3 , Xin Wang  4 , Mauro Orlando  5
Affiliations
Review

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

Dae Ho Lee et al. Cancer Res Treat. 2015 Oct.

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.

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

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Conflict of interest statement

This study was sponsored by Eli Lilly and Company, manufacturer/licensee of pemetrexed (Alimta). Eli Lilly and Company was involved in the design and preparation of the manuscript. RC, XW, and MO are employees of Eli Lilly and Company. RC and MO own shares in Eli Lilly Pty Ltd. DHL has received honoraria from Eli Lilly and Company as a member of an advisory board. VS has no relevant conflicts of interest to declare. Medical writing assistance was provided by Rose Boutros, PhD and Rebecca Lew, PhD, CMPP of ProScribe — Envision Pharma Group, and was funded by Eli Lilly. ProScribe’s services complied with international guidelines for Good Publication Practice (GPP2).

Figures

Fig. 1.
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.
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.
See this image and copyright information in PMC

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