Therapies Directed Against Epidermal Growth Factor Receptor in Aerodigestive Carcinomas

摘要: ContextMalignancies arising from the aerodigestive epithelium, including lung, head and neck, esophageal carcinomas, are leading causes of cancer-related mortality worldwide. Given biological importance epidermal growth factor receptor (EGFR) in cancer development progression, EGFR inhibitors have emerged as promising novel therapies.ObjectivesTo summarize current status carcinomas (ADCs), highlight ongoing research designed to optimize their therapeutic effectiveness, consider future role these agents.Evidence AcquisitionSystematic MEDLINE search English-language literature (1966-April 2007) performed using terms EGFR, inhibitors, monoclonal antibodies, tyrosine kinase lung cancer, neck predictive factors. Quality assessment selected studies included clinical pertinence, with an emphasis on controlled study design, publication peer-reviewed journals, adequate number enrolled patients, objectivity measurements, techniques used minimize bias.Evidence SynthesisThe ADC pathogenesis has been extensively studied, multiple inhibition strategies under evaluation. Erlotinib, inhibitor a single agent, cetuximab, anti-EGFR antibody combination radiation, conferred survival benefit 1 trial patients advanced non–small cell (median survival, 6.7 vs 4.7 months; hazard ratio, 0.70; 95% confidence interval, 0.58-0.87; P < .001) locally squamous carcinoma 49 29.3 0.74; 0.57-0.97; P = .03), respectively. However, other trials not shown degrees improvement. toxicities include rash, diarrhea, hypomagnesemia. Somatic mutations molecular tumoral characteristics offer opportunities for treatment individualization optimal patient selection therapy.ConclusionsEGFR is target ADC. Further translational needed ways inhibiting single-agent or regimens identify who most therapies.