Relationship Between EGFR Expression, EGFR Mutation Status, and the Efficacy of Chemotherapy Plus Cetuximab in FLEX Study Patients with Advanced Non–Small-Cell Lung Cancer

摘要: Introduction: The phase III FLEX study (NCT00148798) in advanced non-small-cell lung cancer indicated that the survival benefit associated with addition of cetuximab to cisplatin and vinorelbine was limited patients whose tumors expressed high lev- els epidermal growth factor receptor (EGFR) (immunohistochem- istry score ≥200; scale 0-300). We assessed whether treatment effect also modulated by tumor EGFR mutation status. Methods: A screen exons 18 21 included 971 1125 (86%) patients. Treatment outcome low expression groups analyzed across efficacy end- points according Results: Mutations were detected 133 (14%), 970 which evaluable for level. most common mutations exon 19 dele- tions L858R (124 patients; 93%). In group (immunohistochemistry ≥200), a chemotherapy demon- strated wild-type (including T790M mutant) tumors. Although patient numbers small, those carried may have derived from chemotherapy. Response data suggested regardless Conclusions: first-line expressing levels is not