A novel mutation in the epidermal growth factor receptor (EGFR) gene that could change the way that EGFR targeted therapies are given to patients with non-small-cell lung cancer is reported in the January 2006 issue of Nature Clinical Practice Oncology.
Results from a molecular analysis of a patient's biopsy, coupled with experimental data could help clinicians decide which EGFR targeted treatment will be more effective for the patient.
Several reports have documented that patients with this type of lung cancer, with mutations in the EGFR gene usually show a beneficial respond to the agents - gefitinib or erlotinib - that target the EGFR.
In the reported case study, a patient with advanced non-small-cell lung cancer and brain metatases who did not respond to treatment with erlotinib showed a remarkable response to gefitinib. Analysis of the patient's tumor cells and accompanying experimental data showed that two mutations in the EGFR gene were present; one of these mutations occurred in a different part of the EGFR gene than previously identified. Choong and colleagues demonstrate that, according to molecular profiling, it is possible to obtain a striking response with an EGFR targeted agent, even in a patient with extensive metastases.
Understanding the molecular basis of tumors might help to predict differential responses to EGFR targeted agents and could guide selection of optimal therapies. Patients with meningeal brain metastases represent a subgroup that could benefit from individualized therapy with such agents.
Author contact details:
Patrick C Ma (Case Comprehensive Cancer Center, Cleveland, OH, USA)
Abstract available online.
(C) Nature Clinical Practice Oncology press release.
Message posted by: Trevor M. D'Souza