Upregulation of HER-2/neu is independent of the menopausal status of primary breast cancer patients: Plasma results from a prospectively randomized trial comparing dose-intense chemotherapy with G-CSF support to 3-weekly chemotherapy for adjuvant therapy of nodal-positive (1–3 LN) breast cancer (German Adjuvant Study Group ASG)

This study aimed to identify predictive factors associated with prognostic benefits of gefitinib. A total of 221 Japanese patients who received gefitinib (250 mg day À1 ) were examined retrospectively and potential predictive factors analysed. Overall response rate (ORR) was 24.4% and median survival time (MST) was 8.0 months. In a log-rank test, survival was significantly better in females, patients with adenocarcinoma, never-smokers, favourable performance status (PS) and patients with epidermal growth factor receptor (EGFR) mutation. The lower the smoking exposure (Brinkman Index (BI) ¼ cigarettes per day Â years smoked), the better the MST (BI 0: 14.5 months, BI o500: 9.5 months, BI 500 to o1000: 6.9 months, BI X1000: 4.0 months). Positive-EGFR mutation status and PS 0 -1 were independent predictors of favourable prognosis by multivariate analysis. Prognosis was significantly different according to EGFR mutation status (with the same smoking status), but not according to smoking status (with the same EGFR mutation status). EGFR mutation status is the most important independent predictor of survival benefit with gefitinib treatment. Although differences in prognosis were observed according to relative smoking status and smoking exposure, the results suggested that smoking is not a direct predictor of prognosis, yet is a surrogate marker of EGFR mutation status.

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Predictive factors associated with prolonged survival in patients with advanced non-small-cell lung cancer (NSCLC) treated with gefitinib

Satouchi

Negoro

Funada

et al. 2007

Br J Cancer

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Epidermal Growth Factor Receptor Inhibition and Non-Small Cell Lung cancer

Eyben¹

2006

Critical Reviews in Clinical Laboratory Sciences

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The majority of non-small cell (NSC) lung cancers express epidermal growth factor receptor (EGFR). Many studies have evaluated the clinical effect from targeted therapy achieved by blocking EGFR in patients with NSC lung cancer. Treatment of biologically unselected patients with NSC lung cancer with two reversible quinazole EGFR inhibitors, gefitinib and erlotinib, gave negative results in all controlled trials but one. Ten percent to 20% of patients with NSC lung cancers have somatic mutations in EGFR, and these patients have a significantly higher response rate (73%) to treatment with EGFR inhibitors than patients with wild-type EGFR (10%). Patients with Asian background, women, non-smokers, and patients with adenocarcinoma had higher response rates than other patients, and the differences may be due to an association between the clinical characteristics and EGFR mutations. Further studies are needed to fully evaluate the effect of EGFR inhibitor-treatment for subgroups of patients with NSC lung cancer with favorable biological and clinical characteristics.

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Prospective Phase II Study of Gefitinib for Chemotherapy-Naïve Patients With Advanced Non–Small-Cell Lung Cancer With Epidermal Growth Factor Receptor Gene Mutations

Inoue

Suzuki

Fukuhara

et al. 2006

JCO

469

281

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Predictive factors associated with prolonged survival in patients with advanced non-small-cell lung cancer (NSCLC) treated with gefitinib

Predictive factors associated with prolonged survival in patients with advanced non-small-cell lung cancer (NSCLC) treated with gefitinib

Epidermal Growth Factor Receptor Inhibition and Non-Small Cell Lung cancer

Prospective Phase II Study of Gefitinib for Chemotherapy-Naïve Patients With Advanced Non–Small-Cell Lung Cancer With Epidermal Growth Factor Receptor Gene Mutations

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