title: EGFR expression and survival in patients given cetuximab and chemoradiation for stage III non-small cell lung cancer: a secondary analysis of RTOG 0324.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States. Electronic address: rkomaki@mdanderson.org.
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Komaki
authors.affiliation: RTOG Statistical Center, Philadelphia, United States.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Paulus
authors.affiliation: Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: George R
authors.initials: GR
authors.lastname: Blumenschein
authors.affiliation: Winship Cancer Institute of Emory University, Atlanta, United States.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Curran
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center, United States.
authors.forename: Francisco
authors.initials: F
authors.lastname: Robert
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States. Electronic address: jthariat@hotmail.com.
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.affiliation: Thomas Jefferson University Hospital, Philadelphia, United States.
authors.forename: Maria
authors.initials: M
authors.lastname: Werner-Wasik
authors.affiliation: The University of Texas Southwestern, Dallas, United States.
authors.forename: Hak
authors.initials: H
authors.lastname: Choy
authors.affiliation: University of Colorado Cancer Center, Aurora, United States.
authors.forename: Fred R
authors.initials: FR
authors.lastname: Hirsch
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Kie Kian
authors.initials: KK
authors.lastname: Ang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D000068818:Cetuximab; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D016190:Carboplatin; D066246:ErbB Receptors; D017239:Paclitaxel; D000068818:Cetuximab
keywords: Cetuximab; Clinical trials identifier NCT00081302; Erbitux; Inoperable lung cancer; RTOG 0324