title: Analysis of the EGFR mutation status in head and neck squamous cell carcinoma before treatment with Gefitinib.
abstract: BACKGROUND
  The efficacy of chemotherapy in metastatic and recurrent squamous cell carcinomas of the head and neck (HNSCC) remains unsatisfactory. Gefitinib offers a new therapeutic option with comparable results and better tolerability than chemotherapy. We conducted this study to see if mutations in the epidermal growth factor receptor (EGFR) might predict the therapeutic benefit in HNSCC patients.
  
  
  METHODS
  In a pilot trial, 8 patients with metastatic or recurrent HNSCC were treated palliatively with gefitinib (500 mg/day orally). Forceps biopsies were taken to confirm tumor recurrence and to perform an EGFR mutation analysis.
  
  
  RESULTS
  The EGFR status could be determined in 6 of the 8 patients. 5 patients had no EGFR gene mutation, and 1 patient showed a silent guanine-to-adenosine mutation in position 2607. Even without any relevant mutation in the EGFR, we observed partial remission in 3 of 6 patients treated with gefitinib. We also observed that an additional 4 patients had stable disease for at least 10 weeks. The median progression-free survival was 6.25 months, and the median overall survival was 7.39 months.
  
  
  CONCLUSIONS
  In HNSCC, there are tumor responses to gefitinib without protein-altering mutations in the EGFR gene.
authors.affiliation: Kopf-Hals-Tumor-Zentrum, Universitätsspital Basel, Switzerland.
authors.forename: Sven
authors.initials: S
authors.lastname: Bontognali
authors.forename: Miklos
authors.initials: M
authors.lastname: Pless
authors.forename: Martin H
authors.initials: MH
authors.lastname: Brutsche
authors.forename: Claude
authors.initials: C
authors.lastname: Fischer
authors.forename: Christoph
authors.initials: C
authors.lastname: Rochlitz
authors.forename: Martin
authors.initials: M
authors.lastname: Buess
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000235:genetics*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D005260:Female; D000077156:Gefitinib; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011799:Quinazolines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib