EGFR Level Predicts Survival Benefit of Cetuximab in NSCLC

Patients with high EGFR expression survive longer if they receive cetuximab in addition to chemo

FRIDAY, Nov. 4 (HealthDay News) -- For patients with advanced non-small-cell lung cancer (NSCLC), high epidermal growth factor receptor (EGFR) expression can predict the survival benefit for the addition of cetuximab to first-line chemotherapy, according to a study published online Nov. 4 in The Lancet Oncology.

Robert Pirker, M.D., from the Medical University Vienna in Austria, and colleagues investigated whether tumor EGFR expression level was associated with clinical outcomes in patients with advanced NSCLC who had benefited from the addition of cetuximab to their first-line chemotherapy in the First-Line ErbituX in lung cancer study. Tumor EGFR expression data from 1,121 patients, from the intention-to-treat population, were used to generate immunohistochemistry scores (on a scale of 0 to 300), with a threshold score of 200 for EGFR expression. Patients with low (<200) and high (≥200) scores were assessed for treatment outcomes.

The investigators found that 31 percent of the patients had high EGFR expression and 69 percent had low expression. The overall survival of patients with high EGFR expression was higher for those receiving chemotherapy plus cetuximab versus chemotherapy alone (median, 12 versus 9.6 months; hazard ratio [HR], 0.73), without a substantial increase in side effects. For patients with low EGFR expression, survival did not significantly differ between the two treatment cohorts (median, 9.8 versus 10.3 months; HR, 0.99; P = 0.88). Testing of the difference in the overall survival HRs suggested that EGFR expression has a predictive value.

"High EGFR expression is a tumor biomarker that can predict survival benefit from the addition of cetuximab to first-line chemotherapy in patients with advanced NSCLC," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies, including Merck KGaA, which funded the study and manufactures cetuximab.

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