Molecular determinants of cetuximab efficacy

D Vallböhmer, W Zhang, M Gordon… - Journal of Clinical …, 2005 - ascopubs.org
D Vallböhmer, W Zhang, M Gordon, DY Yang, J Yun, OA Press, KE Rhodes, AE Sherrod…
Journal of Clinical Oncology, 2005ascopubs.org
Purpose To investigate whether mRNA expression levels of cyclin D1 (CCND1),
cyclooxygenase 2 (Cox-2), epidermal growth factor receptor (EGFR), interleukin 8 (IL-8), and
vascular endothelial growth factor (VEGF), all members of the EGFR signaling pathway, are
associated with clinical outcome in patients with EGFR-expressing metastatic colorectal
cancer (CRC) treated with cetuximab. Patients and Methods Thirty-nine patients with
metastatic CRC, refractory to both irinotecan and oxaliplatin, were enrolled on IMCL-0144 …
Purpose
To investigate whether mRNA expression levels of cyclin D1 (CCND1), cyclooxygenase 2 (Cox-2), epidermal growth factor receptor (EGFR), interleukin 8 (IL-8), and vascular endothelial growth factor (VEGF), all members of the EGFR signaling pathway, are associated with clinical outcome in patients with EGFR-expressing metastatic colorectal cancer (CRC) treated with cetuximab.
Patients and Methods
Thirty-nine patients with metastatic CRC, refractory to both irinotecan and oxaliplatin, were enrolled on IMCL-0144 and treated with single-agent cetuximab. The intratumoral mRNA levels of CCND1, Cox-2, EGFR, IL-8, and VEGF were assessed from paraffin-embedded tissue samples using laser-capture microdissection and quantitative real-time polymerase chain reaction.
Results
There were 21 women and 18 men with a median age of 64 years (range, 35 to 83 years). Higher gene expression levels of VEGF were associated with resistance to cetuximab (P = .038; Kruskal-Wallis test). The combination of low gene expression levels of Cox-2, EGFR, and IL-8 was significantly associated with overall survival (13.5 v 2.3 months; P = .028; log-rank test). Both findings were independent of skin toxicity that was itself significantly correlated to survival. Patients with a lower mRNA amount of EGFR had a longer overall survival compared with patients that had a higher mRNA amount (7.3 v 2.2 months; P = .09; log-rank test). Patients with lower expression of Cox-2 had a significantly higher rate of grade 2 to 3 skin reactions under cetuximab treatment.
Conclusion
This pilot study suggests that gene expression levels of Cox-2, EGFR, IL-8, and VEGF in patients with metastatic CRC may be useful markers of clinical outcome in single-agent cetuximab treatment.
ASCO Publications