title: Modulation of epidermal growth factor receptor status by chemotherapy in patients with locally advanced non-small-cell lung cancer is rare.
abstract: OBJECTIVE
  To determine whether epidermal growth factor receptor (EGFR) expression in non-small-cell lung cancer (NSCLC) is modulated by chemotherapy and to assess the agreement of EGFR status between mediastinal nodes and the primary tumor after chemotherapy.
  
  
  METHODS
  Patients with NSCLC stage IIIa/b pN2/3 confirmed by mediastinoscopy or mediastinostomy were treated with at least three cycles of chemotherapy before undergoing surgery. EGFR expression was evaluated on mediastinal nodes at the time of initial diagnosis and on both the primary tumor and residual metastatic nodes after treatment.
  
  
  RESULTS
  EGFR expression determined on 138 of 164 patients who underwent mediastinoscopy or mediastinostomy was 0 (22 patients), 1+ (27 patients), 2+ (28 patients), and 3+ (61 patients). Fifty-four patients of 164 received chemotherapy followed by surgery. Of the 89 of 138 patients with EGFR score of 2+/3+ at the time of diagnosis, 34 patients underwent surgery after induction chemotherapy. None changed to zero EGFR immunoreactivity, with 29 patients (88%) maintaining a score of 2+/3+. Of the 22 of 138 patients with no EGFR expression at the time of diagnosis, six underwent surgical resection after induction chemotherapy. Of these six patients, four changed their EGFR expression from an EGFR score of 0 to 2+/3+. After treatment, the agreement of EGFR status between tumor and nodes in the subgroup of patients with EGFR score 2+/3+ was 89% to 92%.
  
  
  CONCLUSIONS
  Our data suggest a very good agreement of EGFR status before and after chemotherapy in EGFR-positive NSCLC. Induction chemotherapy can induce EGFR expression in occasional EGFR-negative tumors.
authors.affiliation: Division of Medical Oncology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. tommaso.de-pas@ieo.it
authors.forename: Tommaso
authors.initials: T
authors.lastname: De Pas
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pelosi
authors.forename: Filippo
authors.initials: F
authors.lastname: de Braud
authors.forename: Giulia
authors.initials: G
authors.lastname: Veronesi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Curigliano
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Leon
authors.forename: Romano
authors.initials: R
authors.lastname: Danesi
authors.forename: Cristina
authors.initials: C
authors.lastname: Noberasco
authors.forename: Massimiliano
authors.initials: M
authors.lastname: d'Aiuto
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Catalano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D003131:Combined Modality Therapy; D066246:ErbB Receptors / Q000096:biosynthesis* / Q000187:drug effects*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D020360:Neoadjuvant Therapy
chemical_list: D066246:ErbB Receptors