Analysis of the EGFR Mutation Status in Head and Neck Squamous Cell Carcinoma before Treatment with Gefitinib

Abstract

Background: The efficacy of chemotherapy in metastatic and recurrent squamous cell carcinomas of the head and neck (HNSCC) remains unsatisfactory. Gefitinib offers a new therapeutic option with comparable results and better tolerability than chemotherapy. We conducted this study to see if mutations in the epidermal growth factor receptor (EGFR) might predict the therapeutic benefit in HNSCC patients. Patients and Methods: In a pilot trial, 8 patients with metastatic or recurrent HNSCC were treated palliatively with gefitinib (500 mg/day orally). Forceps biopsies were taken to confirm tumor recurrence and to perform an EGFR mutation analysis. Results: The EGFR status could be determined in 6 of the 8 patients. 5 patients had no EGFR gene mutation, and 1 patient showed a silent guanine-to-adenosine mutation in position 2607. Even without any relevant mutation in the EGFR, we observed partial remission in 3 of 6 patients treated with gefitinib. We also observed that an additional 4 patients had stable disease for at least 10 weeks. The median progression-free survival was 6.25 months, and the median overall survival was 7.39 months. Conclusion: In HNSCC, there are tumor responses to gefitinib without protein-altering mutations in the EGFR gene.

The challenge of blocking a wider family members of EGFR against head and neck squamous cell carcinomas

“…2B). Some of them have also been involved in resistance to EGFR targeted therapies in HNSCC [93][94][95] (Fig. 2B).…”

Production of Specific Anti-EGFR Single Chain Antibodies: A Promising Strategy in the Immunotherapy of EGFR Expressing Tumor Tissues

“…Gefitinib is an oral inhibitor of EGFR tyrosine kinase activity which has shown good antitumor activity in treatment of non-small-cell lung cancer (12) and also head and neck squamous cell carcinoma (13). Erlotinib is another tyrosine kinase inhibitor which has shown antitumor activity in head and neck tumor cell lines, metastatic tumor mass in lung of a patient with primary renal cell carcinoma and is used as a first line treatment of metastatic non-small cell lung cancer with certain EGFR expression (14).…”