Polymorphisms of the epidermal growth factor receptor (EGFR) and survival in patients with advanced cancer of the head and neck (HNSCC).

AIM

Associations between polymorphisms of the epidermal growth factor receptor (EGFR) and overall survival in patients with advanced carcinoma of the head and neck (HNSCC) receiving cetuximab based palliative treatment, were evaluated.

MATERIALS AND METHODS

HNSCC patients (n=48) received cetuximab +/- chemotherapy. Samples for DNA extraction and clinical data were collected prospectively. Genotyping of four EGF(R) polymorphisms was performed using PCR-based restriction fragment length polymorphism (RFLP).

RESULTS

The median overall survival was 10.6 months. The EGFR-R497K polymorphism was significantly associated with overall survival. The presence of at least one K-allele was associated with shorter overall survival. The median survival in these patients was 6.7 months compared to 13.3 months in the patients homozygous for the wild type allele EGFR-497R (p=0.009). Addition of chemotherapy to cetuximab, age and EGFR-R497K polymorphism were independent predictors of overall survival. Multivariate analysis revealed a hazard ratio (HR) for patients with at least one EGFR-497K allele of 3.03 when compared with EGFR-497R homozygous patients (p=0.045).

CONCLUSION

The EGFR-R497K polymorphism is a potential predictor for overall survival in HNSCC patients treated with cetuximab based therapy in the palliative setting.