title: Polymorphisms of EGFR predict clinical outcome in advanced non-small-cell lung cancer patients treated with Gefitinib.
abstract: OBJECTIVE
  Genetic variations in EGFR may alter protein function and therefore the therapeutic efficacy of epidermal growth factor receptor inhibitors. This study investigated the association between polymorphisms in EGFR and clinical outcome in patients with advanced non-small-cell lung cancer (NSCLC) treated with Gefitinib.
  
  
  METHODS
  A whole gene-based tag-SNP approach was used to determine the candidate SNPs in EGFR. Four tag SNPs, one CA simple sequence repeat (CA-SSR) in intron 1, one coding region SNP (R521K), and SNPs identified by resequencing in the tyrosine kinase domain of EGFR were selected to analyze their association with therapeutic outcome and survival in 84 advanced NSCLC patients treated with Gefitinib. Progression-free and overall survivals were computed by Cox model adjusted for clinical factors.
  
  
  RESULTS
  We identified two EGFR polymorphisms, rs2293347 (D994D) and CA-SSR in intron 1, associated with clinical outcome of Gefitinib therapy. The response rate for the rs2293347GG or shorter CA repeat genotype was significantly higher than that for the rs2293347GA or AA or longer CA repeat genotype (71.2% versus 37.5%, P=0.0043 and 88.5% versus 48.3%, P=0.0005). The rs2293347GG genotype was also associated with longer progression-free survival compared with the rs2293347GA or AA genotype (11 months versus 3 months, P=0.0018). A combination of rs2293347GG and shorter CA repeat genotypes had more pronounced clinical benefit.
  
  
  CONCLUSIONS
  The D994D and CA-SSR polymorphisms in EGFR are potential predictors for clinical outcome in advanced NSCLC patients treated with Gefitinib.
authors.affiliation: Department of Medical Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Ma
authors.forename: Tong
authors.initials: T
authors.lastname: Sun
authors.forename: Yuankai
authors.initials: Y
authors.lastname: Shi
authors.forename: Dianke
authors.initials: D
authors.lastname: Yu
authors.forename: Wen
authors.initials: W
authors.lastname: Tan
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.forename: Chen
authors.initials: C
authors.lastname: Wu
authors.forename: Datong
authors.initials: D
authors.lastname: Chu
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.forename: Binghe
authors.initials: B
authors.lastname: Xu
authors.forename: Dongxin
authors.initials: D
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism; D005260:Female; D000077156:Gefitinib; D015870:Gene Expression; D018773:Genes, erbB-1; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011799:Quinazolines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib