Cappuzzo F et al. (2005) Epidermal growth factor receptor gene and protein and gefitinib sensitivity in non-small-cell lung cancer. J Natl Cancer Inst 97: 643–655

Recent research by Cappuzzo et al. suggests that the efficacy of gefitinib treatment in advanced non-small-cell lung cancer (NSCLC) is predicted by the patient's epidermal growth factor receptor (EGFR) gene copy number. If validated in an ongoing, prospective study, these findings might be useful in selecting patients for therapy.

The researchers obtained tumor specimens from 102 NSCLC patients who were due to undergo gefitinib therapy. Using fluorescence in situ hybridization, they determined the EGFR copy number for each tumor. EGFR protein expression, EGFR mutations and Akt activation status were also analyzed. These factors were then compared with the patients' clinical outcomes.

Around one-third of patients had amplification or high polysomy of the EGFR gene, and more than half of the specimens showed high expression of the corresponding protein. Patients displaying either of these characteristics showed significantly better response to treatment, disease control rate, time to progression and survival than seen in patients not displaying increased gene or protein EGFR levels. In a multivariate analysis, a high EGFR gene copy remained significantly associated with improved survival, leading Cappuzzo et al. to conclude that this might be “an effective molecular predictive marker for gefitinib sensitivity in patients with advanced NSCLC”.