title: Insulin-like growth factor receptor 1 (IGFR-1) is significantly associated with longer survival in non-small-cell lung cancer patients treated with gefitinib.
abstract: BACKGROUND
  The aim of the study was to assess whether loss of PTEN and expression of insulin-like growth factor receptor 1 (IGFR-1) could be responsible for intrinsic resistance to the tyrosine kinase inhibitor (TKI) gefitinib.
  
  
  METHODS
  One hundred and twenty-four gefitinib-treated patients with advanced non-small-cell lung cancer (NSCLC) were analyzed for PTEN and IGFR-1 expression by immunohistochemistry.
  
  
  RESULTS
  IGFR-1 was evaluated in 77 patients and resulted positive in 30 (39.0%). IGFR-1 expression was not significantly associated with clinical or biological characteristics. No difference in response to gefitinib treatment (16.7% versus 12.8%, P = 0.74) and time to progression (2.6 versus 3.06 months, P = 0.83) was observed between IGFR-1+ and IGFR-1-. Median survival was significantly longer in IGFR-1+ patients (17.8 versus 7.3 months, P = 0.013). PTEN expression was successfully evaluated in 93 cases. Loss of PTEN was detected in 19 tumors (20.4%) and was not associated with any clinical or biological characteristic. No difference in terms of response, time to progression and survival was observed between PTEN+ and PTEN- patients. In multivariable analysis IGFR-1 negative status was significantly associated with higher risk of death (hazard ratio 2.21, P = 0.012).
  
  
  CONCLUSIONS
  IGFR-1 expression and loss of PTEN are not associated with intrinsic resistance to gefitinib. Clinical relevance of these two biomarkers as determinant for acquired resistance, and the prognostic role of IGFR-1 expression in patients not exposed to TKIs should be evaluated further.
authors.affiliation: University of Colorado Cancer Center, Department of Medicine/Medical Oncology and Pathology, Aurora, USA.
authors.forename: F
authors.initials: F
authors.lastname: Cappuzzo
authors.forename: L
authors.initials: L
authors.lastname: Toschi
authors.forename: G
authors.initials: G
authors.lastname: Tallini
authors.forename: G L
authors.initials: GL
authors.lastname: Ceresoli
authors.forename: I
authors.initials: I
authors.lastname: Domenichini
authors.forename: S
authors.initials: S
authors.lastname: Bartolini
authors.forename: G
authors.initials: G
authors.lastname: Finocchiaro
authors.forename: E
authors.initials: E
authors.lastname: Magrini
authors.forename: G
authors.initials: G
authors.lastname: Metro
authors.forename: A
authors.initials: A
authors.lastname: Cancellieri
authors.forename: R
authors.initials: R
authors.lastname: Trisolini
authors.forename: L
authors.initials: L
authors.lastname: Crino
authors.forename: P A
authors.initials: PA
authors.lastname: Bunn
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.forename: W A
authors.initials: WA
authors.lastname: Franklin
authors.forename: M
authors.initials: M
authors.lastname: Varella-Garcia
authors.forename: F R
authors.initials: FR
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality*; D004351:Drug Resistance; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051059:PTEN Phosphohydrolase / Q000378:metabolism*; D018579:Patient Selection; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D017526:Receptor, IGF Type 1 / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D017526:Receptor, IGF Type 1; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human; D000077156:Gefitinib