Epidermal growth factor receptor status in stages of resected non-small cell lung cancer: implications for treatment with epidermal growth factor receptor inhibitors.

OBJECTIVE

To verify whether epidermal growth factor receptor (EGFR) status could be considered a prognostic factor and assessment of it an effective tool for planning therapy in patients with non-small cell lung cancer (NSCLC).

STUDY DESIGN

From 1996 to 2001, 439 patients underwent radical surgery for NSCLC at the Polytechnic University of the Marche Region. EGFR expression was detected as membranous and/or cytoplasmic staining of neoplastic cells with various intensity and was considered positive when > or = 1% of the tumor cells had membranous staining.

RESULTS

Samples from 423 patients were available for EGFR analysis. EGFR expression and a stronger intensity of staining were associated with a trend for a worse prognosis in the analysis of all of the patients. The subgroup analysis showed no prognostic significance in stages I and II but a significantly longer survival in patients with advanced disease (stage III and particularly N2) overexpressing EGFR.

CONCLUSION

The results of our study, showing a significantly longer survival in patients with advanced disease (stage III, particularly N2) overexpressing EGFR, present a new perspective, both for prognostic evaluation of patients with radically resected NSCLC and for the management of adjuvant treatment also employing targeted therapy.