EGFR expression and survival in patients given cetuximab and chemoradiation for stage III non-small cell lung cancer: A secondary analysis of RTOG 0324

Ritsuko Komaki, Rebecca Paulus, George R. Blumenschein, Walter J. Curran, Francisco Robert, Juliette Thariat, Maria Werner-Wasik, Hak Choy, Fred R. Hirsch, Kie Kian Ang

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Abstract

Purpose: We investigated whether expression of epidermal growth factor receptor (EGFR) was associated with survival and disease control in this secondary analysis of a phase II trial of cetuximab + chemoradiation for stage III non-small cell lung cancer. Methods: Patients received cetuximab weekly before and during radiation (63 Gy/35 fractions/7 weeks) with weekly carboplatin + paclitaxel. We analyzed EGFR expression by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in pretreatment biopsy specimens and compared findings with overall and progression-free survival (OS, PFS) and time to progression (TTP). Results: Specimens for IHC and FISH were collected from 51 and 45 of 87 evaluable patients. Pretreatment characteristics did not differ for patients with (n = 51) or without (n = 36) EGFR IHC data, or with (n = 45) or without (n = 42) FISH data. However, patients without IHC data had worse OS (HR = 1.63, P = 0.05), worse PFS (HR = 1.88, P = 0.008), and worse TTP [HR = 1.99, P = 0.01] than those with IHC data. EGFR protein expression was not related to pretreatment characteristics or OS; FISH-positive disease was associated with better performance status but not with OS, PFS, or TTP. Conclusions: Surprisingly, outcomes differed not by EGFR expression but by the availability of samples for analysis, underscoring the importance of obtaining biopsy samples in such trials.

Original languageEnglish (US)
Pages (from-to)30-36
Number of pages7
JournalRadiotherapy and Oncology
Volume112
Issue number1
DOIs
StatePublished - Jul 1 2014

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Epidermal Growth Factor Receptor
Non-Small Cell Lung Carcinoma
Fluorescence In Situ Hybridization
Immunohistochemistry
Survival
Biopsy
Radiation Dosage
Carboplatin
Paclitaxel
Disease-Free Survival
Cetuximab
Proteins

Keywords

  • Cetuximab
  • Clinical trials identifier NCT00081302
  • Erbitux
  • Inoperable lung cancer
  • RTOG 0324

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

EGFR expression and survival in patients given cetuximab and chemoradiation for stage III non-small cell lung cancer : A secondary analysis of RTOG 0324. / Komaki, Ritsuko; Paulus, Rebecca; Blumenschein, George R.; Curran, Walter J.; Robert, Francisco; Thariat, Juliette; Werner-Wasik, Maria; Choy, Hak; Hirsch, Fred R.; Ang, Kie Kian.

In: Radiotherapy and Oncology, Vol. 112, No. 1, 01.07.2014, p. 30-36.

Research output: Contribution to journalArticle

Komaki, R, Paulus, R, Blumenschein, GR, Curran, WJ, Robert, F, Thariat, J, Werner-Wasik, M, Choy, H, Hirsch, FR & Ang, KK 2014, 'EGFR expression and survival in patients given cetuximab and chemoradiation for stage III non-small cell lung cancer: A secondary analysis of RTOG 0324', Radiotherapy and Oncology, vol. 112, no. 1, pp. 30-36. https://doi.org/10.1016/j.radonc.2014.06.012
Komaki, Ritsuko ; Paulus, Rebecca ; Blumenschein, George R. ; Curran, Walter J. ; Robert, Francisco ; Thariat, Juliette ; Werner-Wasik, Maria ; Choy, Hak ; Hirsch, Fred R. ; Ang, Kie Kian. / EGFR expression and survival in patients given cetuximab and chemoradiation for stage III non-small cell lung cancer : A secondary analysis of RTOG 0324. In: Radiotherapy and Oncology. 2014 ; Vol. 112, No. 1. pp. 30-36.
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AU - Komaki, Ritsuko

AU - Paulus, Rebecca

AU - Blumenschein, George R.

AU - Curran, Walter J.

AU - Robert, Francisco

AU - Thariat, Juliette

AU - Werner-Wasik, Maria

AU - Choy, Hak

AU - Hirsch, Fred R.

AU - Ang, Kie Kian

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AB - Purpose: We investigated whether expression of epidermal growth factor receptor (EGFR) was associated with survival and disease control in this secondary analysis of a phase II trial of cetuximab + chemoradiation for stage III non-small cell lung cancer. Methods: Patients received cetuximab weekly before and during radiation (63 Gy/35 fractions/7 weeks) with weekly carboplatin + paclitaxel. We analyzed EGFR expression by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in pretreatment biopsy specimens and compared findings with overall and progression-free survival (OS, PFS) and time to progression (TTP). Results: Specimens for IHC and FISH were collected from 51 and 45 of 87 evaluable patients. Pretreatment characteristics did not differ for patients with (n = 51) or without (n = 36) EGFR IHC data, or with (n = 45) or without (n = 42) FISH data. However, patients without IHC data had worse OS (HR = 1.63, P = 0.05), worse PFS (HR = 1.88, P = 0.008), and worse TTP [HR = 1.99, P = 0.01] than those with IHC data. EGFR protein expression was not related to pretreatment characteristics or OS; FISH-positive disease was associated with better performance status but not with OS, PFS, or TTP. Conclusions: Surprisingly, outcomes differed not by EGFR expression but by the availability of samples for analysis, underscoring the importance of obtaining biopsy samples in such trials.

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