High epidermal growth factor receptor (EGFR) expression is a good predictor of which lung cancer patients would survive longer when cetuximab (Erbitux?, ImClone LLC/Merck KGaA) was added to first-line chemotherapy, according to research presented at the 14th World Conference on Lung Cancer in Amsterdam, hosted by the International Association for the Study of Lung Cancer (IASLC).

?The new analysis of the Phase III FLEX study has allowed us to identify which non-small cell lung cancer patients are most likely to benefit from treatment with Erbitux in the first-line setting,? said principal investigator Robert Pirker M.D. of the Medical University of Vienna in Austria. ?By demonstrating that high EGFR expression is the first predictive biomarker for improved overall survival in advanced NSCLC, we have taken a major step towards a more personalized approach in this difficult-to-treat disease.”

Benefiting patients
Based on a new analysis of all FLEX patients (1,121 out of 1,125 FLEX study patients), researchers found that patients with high tumor EGFR expression (200 and above on a scale of 0-300) consistently benefited from the addition of cetuximab to chemotherapy regardless of histology. Within this group, overall survival averaged 12 months, compared with 9.6 months for patients receiving chemotherapy alone.

Low EGFR
In patients with low EGFR expression, no difference in overall survival was seen between patients receiving chemotherapy plus cetuximab, compared to those receiving chemotherapy alone.

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For more information:
– Pirker R, Paz Ares L, Eberhardt W, Krzakowski M, St?rkel S, et al. Epidermal growth factor receptor (EGFR) expression as a predictor of survival for first-line chemotherapy plus cetuximab in FLEX study patients with advanced non-small cell lung cancer (NSCLC) Abstract 1557.
– Popper H, Wrba F, Gruber-M?senbacher U, Hulla W, Pirker R, Hilbe W, Studnicka M, Mohn-Staudner A, Ploner F; und die Arbeitsgruppe Pulmopathologie der ?GP-IAP Histology-based algorithm in the molecular diagnosis of mutations of the Epidernal Growth Factor Receptor (EGFR) in non-small cell lung cancer. Wien Klin Wochenschr. 2011 May;123(9-10):316-321. Epub 2011 May 31. German.

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