Epidermal Growth Factor Receptor as a Target to Improve Treatment of Lung Cancer

Andratschke, Nicolaus; Dittmann, Klaus; Mason, Kathryn A.; Fan, Zhen; Liao, Zhongxing; Komaki, Ritsuko; Ang, K. Kian; Milas, Luka

doi:10.3816/clc.2004.n.012

Cited by 7 publications

(2 citation statements)

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“…This trial confirmed preclinical results obtained in different in vitro and in vivo models [9-13]. The NSCLC studies reviewed in the present article suggest that conventional fractionated RT (3-D conformal or intensity-modulated) to a maximum dose of 70 Gy can safely be combined with cetuximab.…”

Section: Discussionsupporting

confidence: 87%

“…Moreover, radiation dose escalation does not address the issue of distant or out-of-field relapses. Based on the fact that the epidermal growth factor receptor (EGFR) is often over-expressed or mutated in NSCLC, the impact of such changes on cellular responses to ionising radiation has been explored [9-11]. Several drugs interfering with the EGFR signalling pathway have been developed, e.g.…”

Section: Introductionmentioning

confidence: 99%

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A review of clinical trials of cetuximab combined with radiotherapy for non-small cell lung cancer

et al. 2012

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Treatment of non-small cell lung cancer (NSCLC) is challenging in many ways. One of the problems is disappointing local control rates in larger volume disease. Moreover, the likelihood of both nodal and distant spread increases with primary tumour (T-) stage. Many patients are elderly and have considerable comorbidity. Therefore, aggressive combined modality treatment might be contraindicated or poorly tolerated. In many cases with larger tumour volume, sufficiently high radiation doses can not be administered because the tolerance of surrounding normal tissues must be respected. Under such circumstances, simultaneous administration of radiosensitizing agents, which increase tumour cell kill, might improve the therapeutic ratio. If such agents have a favourable toxicity profile, even elderly patients might tolerate concomitant treatment. Based on sound preclinical evidence, several relatively small studies have examined radiotherapy (RT) with cetuximab in stage III NSCLC. Three different strategies were pursued: 1) RT plus cetuximab (2 studies), 2) induction chemotherapy followed by RT plus cetuximab (2 studies) and 3) concomitant RT and chemotherapy plus cetuximab (2 studies). Radiation doses were limited to 60-70 Gy. As a result of study design, in particular lack of randomised comparison between cetuximab and no cetuximab, the efficacy results are difficult to interpret. However, strategy 1) and 3) appear more promising than induction chemotherapy followed by RT and cetuximab. Toxicity and adverse events were more common when concomitant chemotherapy was given. Nevertheless, combined treatment appears feasible. The role of consolidation cetuximab after RT is uncertain. A large randomised phase III study of combined RT, chemotherapy and cetuximab has been initiated.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%