title: The relation of EGFR expression by immunohistochemical staining and clinical response of combination treatment of nimotuzumab and chemotherapy in esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The esophageal squamous cell carcinoma (ESCC) is the predominant pathological type and accounts for more than 80 % of esophageal cancer in China. The successful use of anti-epidermal growth factor receptor (EGFR) treatment in head and neck squamous cell carcinoma provides the rationale for introducing anti-EGFR targeting treatment in ESCC. One of our prospective phase II clinical trials analyzed the efficacy of nimotuzumab, an anti-EGFR agent, combined with chemotherapy (paclitaxel and cisplatin) to treat unresectable ESCC.
  
  
  METHODS
  We analyzed the correlation of the clinical response with EGFR expression by immunohistochemical staining (IHC).
  
  
  RESULTS
  Totally 55 tumor samples were analyzed. 18/55 (32.7 %) cases were with high EGFR expression while the other 37/55 (67.3 %) cases were with low to moderate EGFR expression. The expression of EGFR was not related to gender, age, tumor location, tumor differentiation and clinical stage of disease. The objective response rate (ORR) in high EGFR expression group was 55.6 % (10/18) while that in low to moderate EGFR expression group was 54.1 % (20/37) (P = 0.57). Both the progression-free survival (PFS) and overall survival (OS) in high EGFR expression group were much shorter than those in low to moderate EGFR expression group (PFS: 5.8 ± 0.5 vs. 11.0 ± 2.8 months, P = 0.007; OS: 9.7 ± 0.5 vs. 21.5 ± 1.5 months, P = 0.03).
  
  
  CONCLUSIONS
  The results showed that over-expression of EGFR was related to poor survival of ESCC. The over-expression of EGFR by IHC might not be an ideal predictive biomarker of nimotuzumab treatment. Other EGFR pathway-associated molecules should be analyzed in further studies.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, 100142, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Jia
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, 100142, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: M
authors.initials: M
authors.lastname: Lu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Gao
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Gong
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, 100142, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Yu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, 100142, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, 100142, Beijing, China.
authors.forename: C
authors.initials: C
authors.lastname: Liu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The Gastrointestinal Department, Peking University Cancer Hospital and Institute, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Shen
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, 100142, Beijing, China. zhangxd0829@163.com.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000096:biosynthesis*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; C501466:nimotuzumab; C512478:EGFR protein, human; D066246:ErbB Receptors; D017239:Paclitaxel; D002945:Cisplatin
keywords: Epidermal growth factor receptor; Esophageal squamous cell carcinoma; Nimotuzumab