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Epidermal Growth Factor Receptor (EGFR) Pathway Biomarkers in the Randomized Phase III Trial of Erlotinib Versus Observation in Ovarian Cancer Patients with No Evidence of Disease Progression after First-Line Platinum-Based Chemotherapy.

AbstractBACKGROUND:
In this work, we aimed to identify molecular epidermal growth factor receptor (EGFR) tissue biomarkers in patients with ovarian cancer who were treated within the phase III randomized European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group (EORTC-GCG) 55041 study comparing erlotinib with observation in patients with no evidence of disease progression after first-line platinum-based chemotherapy.
METHODS:
Somatic mutations in KRAS, BRAF, NRAS, PIK3CA, EGFR, and PTEN were determined in 318 (38 %) and expression of EGFR, pAkt, pMAPK, E-cadherin and Vimentin, and EGFR and HER2 gene copy numbers in 218 (26 %) of a total of 835 randomized patients. Biomarker data were correlated with progression-free survival (PFS) and overall survival (OS).
RESULTS:
Only 28 mutations were observed among KRAS, BRAF, NRAS, PIK3CA, EGFR, and PTEN (in 7.5 % of patients), of which the most frequent were in KRAS and PIK3CA. EGFR mutations occurred in only three patients. When all mutations were pooled, patients with at least one mutation in KRAS, NRAS, BRAF, PIK3CA, or EGFR had longer PFS (33.1 versus 12.3 months; HR 0.57; 95 % CI 0.33 to 0.99; P = 0.042) compared to those with wild-type tumors. EGFR overexpression was detected in 93 of 218 patients (42.7 %), and 66 of 180 patients (36.7 %) had EGFR gene amplification or high levels of copy number gain. Fifty-eight of 128 patients had positive pMAPK expression (45.3 %), which was associated with inferior OS (38.9 versus 67.0 months; HR 1.81; 95 % CI 1.11 to 2.97; P = 0.016). Patients with positive EGFR fluorescence in situ hybridization (FISH) status had worse OS (46.1 months) than those with negative status (67.0 months; HR 1.56; 95 % CI 1.01 to 2.40; P = 0.044) and shorter PFS (9.6 versus 16.1 months; HR 1.57; 95 % CI 1.11 to 2.22; P = 0.010). None of the investigated biomarkers correlated with responsiveness to erlotinib.
CONCLUSIONS:
In this phase III study, increased EGFR gene copy number was associated with worse OS and PFS in patients with ovarian cancer. It remains to be determined whether this association is purely prognostic or is also predictive.
AuthorsEvelyn Despierre, Ignace Vergote, Ryan Anderson, Corneel Coens, Dionyssios Katsaros, Fred R Hirsch, Bram Boeckx, Marileila Varella-Garcia, Annamaria Ferrero, Isabelle Ray-Coquard, Els M J J Berns, Antonio Casado, Diether Lambrechts, Antonio Jimeno, European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group (EORTC-GCG), Groupe d’Investigateurs Nationaux pour les Etudes des Cancers de l’Ovaire (GINECO), Austrian Arbeitsgemeinschaft für Gynäkologische Onkologie (A-AGO), National Cancer Research Institute (NCRI), Australia New Zealand Gynaecological Oncology Group (ANZGOG), Mario Negri Gynecologic Oncology group (MaNGO)
JournalTargeted oncology (Target Oncol) Vol. 10 Issue 4 Pg. 583-96 (Dec 2015) ISSN: 1776-260X [Electronic] France
PMID26004768 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Biomarkers, Tumor
  • Organoplatinum Compounds
  • Protein Kinase Inhibitors
  • Erlotinib Hydrochloride
  • Protein Kinases
  • EGFR protein, human
  • ErbB Receptors
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Biomarkers, Tumor (genetics, metabolism)
  • Disease Progression
  • Disease-Free Survival
  • ErbB Receptors (genetics, metabolism)
  • Erlotinib Hydrochloride (therapeutic use)
  • Female
  • Humans
  • Middle Aged
  • Mutation
  • Organoplatinum Compounds (administration & dosage)
  • Ovarian Neoplasms (drug therapy, enzymology, genetics)
  • Protein Kinase Inhibitors (therapeutic use)
  • Protein Kinases (genetics, metabolism)

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