PMID- 18367287
OWN - NLM
STAT- MEDLINE
DCOM- 20080923
LR  - 20181201
IS  - 0169-5002 (Print)
IS  - 0169-5002 (Linking)
VI  - 60
IP  - 2
DP  - 2008 May
TI  - EGFR FISH versus mutation: different tests, different end-points.
PG  - 160-5
LID - 10.1016/j.lungcan.2008.02.008 [doi]
AB  - Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) 
      demonstrated to significantly improve survival of non-small cell lung cancer 
      patients (NSCLC) previously exposed to chemotherapy. Although clinical features, 
      particularly smoking history, help physicians for identifying the sensitive 
      population, a proper patient selection should not preclude to drug target 
      assessment. EGFR mutations or increased EGFR gene copy number assessed by 
      fluorescence in situ hybridization (FISH) identify NSCLC with the highest chance 
      to respond to the therapy. Although indirect comparisons suggest that mutation 
      analysis is the best available technique for identification of responders, 
      survival improvement is not confined to individuals with tumor shrinkage. For 
      patients with metastatic NSCLC, where definitive cure in not achievable, response 
      is probably not the best end-point, since survival improvement observed with TKI 
      included also patients with stable or progressive disease. Data from large 
      randomized studies indicated that FISH technology is probably the best method for 
      patient selection when the main end-point is survival. FISH was the only EGFR 
      test significantly associated with prolonged survival in large randomized trials 
      with a control arm of placebo, the only studies able to discriminate between 
      predictive and prognostic value of such biomarkers. Moreover, in absence of any 
      convincing data on the prognostic role of EGFR FISH or EGFR mutations, results 
      from large phase III trials suggest that patients with clinical or biological 
      predictors for TKI sensitivity survive longer when exposed to standard 
      chemotherapy, a relevant aspect that should be considered in designing clinical 
      trials.
FAU - Cappuzzo, Federico
AU  - Cappuzzo F
AD  - Istituto Clinico Humanitas IRCCS, Division of Oncology-Hematology, via Manzoni 
      56, 20089 Rozzano, Italy. federico.cappuzzo@humanitas.it
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20080325
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/genetics
MH  - Clinical Trials as Topic
MH  - *DNA Mutational Analysis
MH  - Drug Resistance, Neoplasm/genetics
MH  - ErbB Receptors/antagonists & inhibitors/*genetics
MH  - Humans
MH  - *In Situ Hybridization, Fluorescence
MH  - Lung Neoplasms/*drug therapy/genetics
MH  - Mutation
MH  - Protein Kinase Inhibitors/*therapeutic use
RF  - 49
EDAT- 2008/03/28 09:00
MHDA- 2008/09/24 09:00
CRDT- 2008/03/28 09:00
PHST- 2007/12/05 00:00 [received]
PHST- 2008/02/11 00:00 [revised]
PHST- 2008/02/14 00:00 [accepted]
PHST- 2008/03/28 09:00 [pubmed]
PHST- 2008/09/24 09:00 [medline]
PHST- 2008/03/28 09:00 [entrez]
AID - S0169-5002(08)00069-X [pii]
AID - 10.1016/j.lungcan.2008.02.008 [doi]
PST - ppublish
SO  - Lung Cancer. 2008 May;60(2):160-5. doi: 10.1016/j.lungcan.2008.02.008. Epub 2008 
      Mar 25.